REGULAR ARTICLE Mother–child relationships, family context, and child characteristics as predictors of anxiety symptoms in middle childhood KATHRYN A. KERNS, SHANNON SIENER, AND LAURA E. BRUMARIU Kent State University Abstract The goal of the study was to examine several factors that may explain the development of anxiety symptoms in middle childhood. Using data from the NICHD Study of Early Child Care (n ¼ 1,364 families), we examined mother–child relationships, other aspects of family context, and child characteristics as predictors of anxiety in preadolescence. Latent growth curve analyses revealed that children whowere more anxious at the beginning of middle childhood had been more behaviorally inhibited as preschoolers, and in middle childhood lived in families who experienced more negative life events and had mothers whowere more anxious. Children who became more anxious across middle childhood were less behaviorally inhibited as preschoolers and in middle childhood perceived less security in their attachments to their mothers, experienced more negative life events, and had mothers who were more anxious. The findings illustrate the need to include a broad set of risk factors in etiological models of anxiety. In addition, the evidence for cumulative effects suggests several possible points of intervention with anxious children and their parents. Anxiety disorders are one of the most common psychiatric disorders in children (Albano, Chorpita, & Barlow, 2003), and one of the costliest mental health problems (Kessler & Greenberg, 2002). Although there has been substantial prog- ress in identifying factors that lead to the development and maintenance of another form of internalizing symptoms, child- hood depression, much less is known regarding the factors re- lated to childhood anxiety (Albano et al., 2003). In addition to causing internal distress, anxiety problems in children are asso- ciated with difficulties in meeting typical developmental chal- lenges. For example, children who manifest anxiety symptoms in middle childhood show difficulties in their relationships with parents and peers (LaGreca & Harrison, 2005; McLeod, Wood, & Weisz, 2007), deficits in school performance (Albano et al., 2003), and are more likely to develop depression in ado- lescence (Zahn-Waxler, Klimes-Dougan, & Slattery, 2000). It is therefore important to understand factors related to the de- velopment and maintenance of childhood anxiety symptoms. Etiological models of anxiety have identified several differ- ent potential influences on the development of anxiety symp- toms (Brumariu & Kerns, 2010; Rapee, 2001; Vasey & Dadds, 2001; Weems & Stickle, 2005). Most commonly, models focus on parent–child relationships, other aspects of the family context, and child characteristics. Two aspects of parent–child relationships that have been linked to anxiety are the security of children’s attachments and the quality of parenting. Studies of attachment are based on Bowlby’s (1982) theorizing that the absence of a secure base can lead to free floating anxiety. Spe- cifically, children who are able to use a parent as a secure base from which to explore and as a haven of safety in times of distress, and who are confident in the parent’s future availabil- ity, are expected to experience less anxiety than children who lack a secure base. In empirical studies insecure attachment has been identified as a risk factor for the development of anx- iety disorders in preschoolers (Shamir-Essakow, Ungerer, & Rapee, 2005) and adolescents (Warren, Huston, Egeland, & Sroufe, 1997). Insecure attachment is also related to elevated levels of anxiety symptoms (Costa & Weems, 2005; Papini, Roggman, & Anderson, 1991; Roelofs, Meesters, Huurne, Ba- melis, & Muris, 2006; van Brakel, Muris, Bogels, & Thomas- son, 2006; but for exceptions, see Bosquet & Egeland, 2006; Feng, Shaw, & Silk, 2008). Insecure attachment also has been linked with higher rates of specific anxiety symptoms in chil- dren, including school phobia (Bar-Heim, Dan, Eshel, & Sagi-Schwartzl, 2007), separation anxiety (Moss, Smolla, Cyr, Dubois-Comtois, Mazzarello, & Berthiaume, 2006), and social anxiety (Bar-Heim et al., 2007; Bohlin, Hagekull, & Ry- dell, 2000; Brumariu & Kerns, 2008). Address correspondence and reprint requests to: Kathryn Kerns, Depart- ment of Psychology, Kent State University, Kent, OH 44242; E-mail: kkerns@ kent.edu. This study was based on data from the NICHD Study of Early Child Care. The NICHD support for the data collection is gratefully acknowledged. Pre- paration of this manuscript was facilitated by a fellowship from the Kent State University Research Council. We thank Manfred van Dulmen for providing statistical consultation. Development and Psychopathology 23 (2011), 593–604 # Cambridge University Press 2011 doi:10.1017/S0954579411000228 593