Family accommodation in pediatric anxiety disorders

Eli R. Lebowitz, Joseph Woolston, Yair Bar-Haim, Lisa Calvocoressi, Christine Dauser, Erin Warnick, Lawrence Scahill, Adi R. Chakir, Tomer Shechner, Holly Hermes, Lawrence A. Vitulano, Robert A. King, James F. Leckman

Research output: Contribution to journalArticlepeer-review


Background 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. Methods 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. Results 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. Conclusions 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.

Original languageEnglish
Pages (from-to)47-54
Number of pages8
JournalDepression and Anxiety
Issue number1
StatePublished - Jan 2013
Externally publishedYes


  • anxiety disorders
  • cognitive behavioral therapy
  • family accommodation
  • family members
  • obsessive compulsive disorder
  • treatment outcomes

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


Dive into the research topics of 'Family accommodation in pediatric anxiety disorders'. Together they form a unique fingerprint.

Cite this