Anxiety Disorders 22 (2008) 263–272

Relations among perceived parental rearing behaviors,

attachment style, and worry in anxious children
Amy M. Brown *, Stephen P. Whiteside
Department of Psychiatry & Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
Received 14 September 2006; received in revised form 9 February 2007; accepted 19 February 2007

Abstract
The present study extended the findings of Muris et al. [Muris, P., Meesters, C., Merckelbach, H., & Hulsenbeck, P. (2000).
Worry in children is related to perceived parental rearing and attachment. Behavior Research and Therapy, 38, 487–497] regarding
the relations between perceived parental rearing behaviors, self-reported attachment style, and worry in a community sample to a
clinical sample of anxious children. Sixty-four children and adolescents, aged 7–18 years, with a primary anxiety disorder
completed (a) the EMBU-C, a questionnaire measuring perceptions of parental rearing behaviors, (b) a single-item measure of
attachment style, and (c) an index of worry severity. Findings revealed that child rated parental rearing behaviors, particularly
parental rejection, were positively related to child worry. Self-reported attachment style was also related to worry, such that children
who classified themselves as ambivalently attached reported higher levels of worry than did children who classified themselves as
securely attached. Parenting style and attachment were found to make independent contributions to worry. The results are compared
to those from Muris et al.’s community study, and implications for future research are discussed.
# 2007 Elsevier Ltd. All rights reserved.

Keywords: Childhood anxiety disorders; Worry; Attachment; Parental rearing behaviors

Current conceptualizations view anxiety disorders as
a combination of biological (Hettema, Prescott, Myers,
Neale, & Kendler, 2005; Stoppel, Albrecht, Pape, &
Stork, 2006; Weissman, 1993) and psychosocial factors
(Albano, Chorpita, & Barlow, 2003; see Rapee, 1997 for
a review; Whaley, Pinto, & Sigman, 1999). Over the
past few decades, researchers have increasingly focused
on the role that parents play in the development and
maintenance of anxiety disorders in children and
adolescents (e.g., Cobham, Dadds, & Spence, 1999;
Siqueland, Kendall, & Steinberg, 1996). Parental
* Corresponding author. Tel.: +1 507 284 5849;
fax: +1 507 284 4158.
E-mail address: brown.amy@mayo.edu (A.M. Brown).
characteristics, such as temperament, anxiety symp-
toms, modeling of anxious behavior, and parental
crianza
rearing behaviors, are thought to contribute to child-
hood anxiety problems. To evaluate this model, studies
have utilized a variety of assessment strategies and
identified several parental rearing behaviors associated
with childhood anxiety. The present study aimed to
investigate the use of a self-report questionnaire
measuring children’s perceptions of parental rearing
behaviors, the EMBU (Swedish acronym for ‘‘My
memories of upbringing’’) for children (EMBU-C;
Castro, Toro, Van der Ende, & Arrindell, 1993; Gruner,
Muris, & Merckelbach, 1999), with clinically anxious
children. Although the EMBU-C has been successfully
used to explore associations among children’s worry
and perceptions of parental rearing behaviors in

0887-6185/$ – see front matter # 2007 Elsevier Ltd. All rights reserved.
doi:10.1016/j.janxdis.2007.02.002
264 A.M. Brown, S.P. Whiteside / Journal of Anxiety Disorders 22 (2008) 263–272
community studies, it has not yet been adequately
evaluated in a clinical population of anxious children.
1. Parental rearing behaviors
In a review of the literature on the relation between
parenting and childhood anxiety, Wood, McLeod,
Sigman, Hwang, and Chu (2003) concluded that
childhood anxiety is most consistently associated with
three parenting dimensions: parental control (i.e.,
overprotectiveness), acceptance, and modeling of
anxious/avoidant behavior. Indeed, empirical research
has found that parents of anxious children are more
overprotective (Messer & Beidel, 1994; Silverman,
Cerny, & Nelles, 1988), less accepting (Scott, Scott, &
McCabe, 1991; Moore, Whaley, & Sigman, 2004), and
less granting of psychological autonomy (Barrett,
Shortt, & Healy, 2002; Siqueland et al., 1996) than
parents of non-anxious children. In particular, through
direct observation of parent–child interactions, Sique-
land et al. found that parents of anxious children were
less tolerant of differences of opinion, demonstrated
less respect for the child’s views, and exhibited more
judgmental or dismissive reactions, than parents of non-
anxious children. In the study by Moore et al., mothers
of anxious children, regardless of their own level of
anxiety, were less warm compared to mothers of non-
anxious children. The authors concluded that maternal
criticism and rejection play a significant role in the
development of childhood anxiety. Other studies, such
as those by Barrett and colleagues (see Dadds & Barrett,
1996 for a review), found that parents of anxious
children model anxious behaviors and maladaptive
problem solving strategies that lead to behavioral
avoidance in children (Barrett, Rapee, Dadds, & Ryan,
1996; Chorpita, Albano, & Barlow, 1996).
To date, most research examining anxious indivi-
duals’ perceptions of their parents’ rearing behaviors
has been retrospective. While most studies have
demonstrated differences in perceived parental rearing
behaviors between individuals with and without anxiety
disorders, specific findings have often been contra-
dictory (Alonso et al., 2004; Turgeon, O’Connor,
Marchand, & Freeston, 2002). For example, Alonso
et al. recently employed the EMBU to assess recall of
parental rearing behaviors among OCD adult out-
patients and healthy controls. Patients with OCD
reported higher levels of rejection from their fathers
during their childhood as compared to healthy controls.
In addition, low levels of parental emotional warmth
partially predicted the presence of hoarding symptoms
among OCD patients. The authors did not find a
difference regarding perceived parental overprotection
between the groups. This was surprising given the
numerous studies describing high levels of parental
overprotection in OCD patients (Merkel, Pollard,
Wiener, & Staebler, 1993; Turgeon et al., 2002). One
such study completed by Turgeon et al. compared
outpatients with panic disorder with agoraphobia
(PDA), outpatients with OCD, and non-anxious con-
trols. Findings were similar among patients with OCD
and PDA, such that they were more likely to rate their
parents (both mothers and fathers) as more over-
protective compared to healthy controls. In contrast, no
differences emerged between the anxious and non-
anxious groups regarding perceived rejection or
emotional warmth. Thus, results have been contra-
dictory and often criticized for the retrospective nature
of the data. Indeed, recollections of parental practices
experienced during childhood are limited not only due
to anxious symptoms but also the duration of time since
childhood that may bias their recall.
While structured parent–child interaction tasks and
retrospective studies can provide useful information,
clinicians working with anxious children would benefit
from the ease and clinical utility of child self-report
questionnaires that assess children’s perceptions of
parental rearing behaviors. Such information would
have significant implications for the treatment of
childhood anxiety at the family level. To date, few
self-report measures have been developed (e.g., EMBU-
C; Castro et al., 1993; Gruner et al., 1999; e.g., CRPBI-
30; Schludermann & Schludermann, 1970), and
empirical data to support their use with clinically
anxious children are sparse (Bogels, van Oosten, Muris,
& Smulders, 2001).
In an effort to offer a child report measure of parental
rearing behaviors, the adult version of the EMBU
(Perris, Jacobsson, Lindstrom, von Knorring, & Perris,
1980), a retrospective measure pertaining to the
childhoods of adults, was modified for use with
children. The EMBU-C (Castro et al., 1993; Gruner
et al., 1999) is a child-report questionnaire assessing
four parental rearing behaviors: emotional warmth,
overprotection/control, anxious rearing, and rejection.
Community studies by Muris et al. using the EMBU-C
have generally demonstrated significant and positive
associations between perceived parental anxious rear-
ing, rejection, and control, on the one hand, and
children’s anxiety symptoms, on the other hand (Gruner
et al., 1999; Muris & Merchelbach, 1998).
Conversely, studies with clinical samples of children
have not found significant differences. For instance, no
associations were found between parental rearing
 A.M. Brown, S.P. Whiteside / Journal of Anxiety Disorders 22 (2008) 263–272
behaviors and children’s internalizing problems among
a diverse clinical sample of children with internalizing
and externalizing disorders (Muris, Bogels, Meesters,
van der Kamp, & van Oosten, 1996). Notably, this study
had a small sample of children with anxiety disorders
(n = 14) and combined the EMBU-C into two factors,
positive and negative rearing behavior, rather than
examining the original four subscales. In another study
that compared a diverse clinical group of high socially
anxious children to a low socially anxious clinical group
and a healthy control group, Bogels et al. (2001)
revealed differences, although not statistically signifi-
cant, in the expected direction on parental rejection and
emotional warmth from the EMBU-C. Again, this study
was comprised of a diverse clinical group (e.g., anxiety
disorder, ADHD, mood disorder) and relatively small
group sizes (n = 20). Therefore, further research using
the EMBU-C with children diagnosed with anxiety
disorders is warranted in order to determine the clinical
utility of this questionnaire and to guide interpretation
of scores among this population.
1.1. Attachment and parenting
One way in which parental rearing behaviors affects
children’s worry and anxiety is through the parent–child
attachment relationship (Bowlby, 1973; Cassidy, 1994).
Children are characterized as securely or insecurely
attached based on the extent to which parent–child
interactions bestow a sense of security and confidence
in the child (Thompson, 2004). With secure parent–
child attachment, infants feel confident in their
caregiver’s ability to respond to their needs, while with
insecure attachment, infants experience a sense of
uncertainty and anxiety about the caregiver’s avail-
ability and assistance (Cassidy & Berlin, 1994;
Thompson, 1999, 2004). Attachment theorists (Ains-
worth, Blehar, Waters, & Wall, 1978; Bowlby, 1973)
have described two main types of insecure attachment:
avoidant and ambivalent attachment styles. Avoidantly
attached infants and young children tend to have
mothers who frequently reject them when they seek
contact. This leads the child to purposely avoid contact
with their caregivers upon reunion as a means to cope
with the rejection. Infants with ambivalent attachment
relationships tend to have mothers who provide
inconsistent or intrusive caregiving. These infants tend
to express both anxious and angry behaviors toward
their caregiver.
Empirical research demonstrates that children with
insecure attachments, either avoidant or ambivalent, are
at greater risk for heightened levels of fear and anxiety
265
as well as associated psychosocial problems (e.g.,
behavior problems, social withdrawal; Kirsh & Cassidy,
1997; Rubin & Mills, 1991). Similarly, retrospective
research found that anxious adults are more likely than
non-anxious adults to describe themselves as insecurely
attached to their caregivers during childhood (Myhr,
Sookman, & Pinard, 2004). Further, based on long-
itudinal data, Warren, Huston, Egeland, and Sroufe
(1997) found that adolescents who were classified as
anxiously and resistantly (i.e., ambivalently) attached as
infants were two times more likely to meet criteria for
an anxiety disorder (e.g., social phobia, generalized
anxiety disorder) than adolescents previously classified
with secure or avoidant attachment. Further, ambivalent
attachment was found to be a stronger predictor for the
presence of an anxiety disorder in adolescence than both
maternal anxiety symptoms and infant temperament,
suggesting that ambivalent attachment influenced the
likelihood of an anxiety disorder to a greater degree
than these individual factors.
In an effort to combine the literature on attachment
and parenting in anxiety, Muris, Meesters, Merck-
elbach, and Hulsenbeck (2000) examined the relation-
ship between perceived parental rearing behaviors and
children’s reported attachment style, on the one hand,
and children’s level of worry, on the other hand.
Findings from a community sample of school-aged
children revealed that children who classified them-
selves as avoidantly or ambivalently attached reported
higher levels of worry than children who classified
themselves as securely attached. Similarly, children’s
rating of parental rejection and anxious rearing were
related to higher levels of worry. Moreover, parental
behaviors and attachment style contributed indepen-
dently to child worry. This study demonstrated how
family environmental factors contribute to children’s
anxiety symptoms. To date, these relations have not
been studied among clinical samples of anxious
children.
1.2. The present study
The current study sought to replicate and extend
findings by Muris, Meesters, et al. (2000) by testing
whether the relations between two family environ-
mental factors, children’s attachment style and per-
ceived parental rearing behaviors, on the one hand, and
children’s self-reported level of child worry, on the
other hand, endure within a clinical sample of anxious
children. This study contributes to the field by (a)
providing a greater understanding of the relationship
between worry and family variables within a population
266 A.M. Brown, S.P. Whiteside / Journal of Anxiety Disorders 22 (2008) 263–272
of clinically anxious children, and (b) being the first
study to our knowledge to use the EMBU-C with a
clinical sample comprised solely of anxious children.
Consistent with Muris et al., it was hypothesized that
children who classify themselves as insecurely attached
(i.e., avoidant, ambivalent) will report a higher level of
worry compared to children who classify themselves as
securely attached. Furthermore, children who perceive
their parents as engaging in rejecting, controlling, and
anxious rearing behaviors will report a higher level of
worry. Finally, it was hypothesized that step-wise
regressions will reveal that both insecure attachment
and negative parental rearing behaviors explain
significant and separate proportions of the variance of
anxious children’s worry.
2. Method
2.1. Participants
Sixty-four children (44 males and 20 females) who
were evaluated in a Child & Adolescent Anxiety
Disorders Clinic in a large Midwestern medical center
participated in the present study. All children presented
with an anxiety disorder as their principal diagnosis.
Twenty-four (36.9%) had a principal diagnosis of OCD,
13 (20%) had GAD, 8 (12.3%) had social phobia, 6
(9.4%) had separation anxiety disorder, 4 (6.2%) had
specific phobia, 1 (1.5%) had panic disorder, and 8
(12.2%) had other anxiety disorders (e.g., anxiety
disorder, NOS). Axis I comorbidity was relatively
common (60.9%), and many children had multiple
anxiety diagnoses (37.5%) and/or an additional
diagnosis of a mood disorder (15.6%). Children ranged
from 7 to 18 years old (M = 13.45 years, S.D. = 3.06). A
majority of the children’s parents were married (89.3%)
and had at least a 2-year college degree (89.3% mothers,
76.8% fathers). The sample was predominantly
Caucasian (92.9%).
2.2. Setting and procedure
All children were evaluated in a child anxiety
disorders center within a large Department of Psy-
chiatry and Psychology. The parents and children were
evaluated by a Ph.D.-level psychologist or a Master’s-
level therapist who specializes in providing both
consultative and treatment/follow-up services. Children
were referred from a wide variety of sources including
self-referral, physicians, and mental health profes-
sionals with the goal of obtaining diagnostic clarifica-
tion and treatment recommendations. Questionnaires
were completed by the children prior to or during their
initial evaluation.
2.3. Materials
2.3.1. Diagnostic status
Diagnoses were determined by the interviewing
psychologist for all patients. All diagnoses were made
consistent with the criteria outlined in the Diagnostic
and Statistical Manual-IV-TR (APA, 2000).
2.3.2. Parental rearing
The modified version of the EMBU-C (Castro et al.,
1993; Gruner et al., 1999) was completed by the
children to assess their current perceptions of their
parents’ rearing behaviors. The questionnaire consists
of 40 items, which are collapsed into four subscales
representing domains of parental rearing behaviors:
emotional warmth, overprotection, rejection, and
anxious rearing. Examples of items include: ‘‘When
you are unhappy, your parents console you and cheer
you up’’ (emotional warmth), ‘‘When you come home,
you have to tell your parents what you’ve been doing’’
(overprotection), ‘‘If something happens at home,
you’re the one who gets blamed for it’’ (rejection),
and ‘‘Your parents are afraid when you do something on
your own’’ (anxious rearing). Items are answered using
a four-point Likert scale (1 = No, never; 2 = Yes, but
seldom; 3 = Yes, often; 4 = Yes, most of the time). For
each EMBU-C item, children answered based on their
current perceptions of both parents’ rearing behaviors
combined. Cronbach’s alphas for this study were as
follows: emotional warmth = .89, overprotection = .64,
rejection = .83, anxious rearing = .81.
2.3.3. Children’s worry
The Penn-State Worry Questionnaire for Children
(PSWQ-C; Chorpita, Tracey, Brown, Collica, &
Barlow, 1997) was completed by children to assess
their level of worry. The questionnaire consists of 14
items using a 4-point Likert scale (0 = never, 1 = some-
times, 2 = often, 3 = always) with a total score ranging
between 0 and 42. Higher scores reflect greater levels of
worry.
2.3.4. Attachment
Taken from Muris, Meesters, et al. (2000), a simplified
version of Hazan and Shaver’s (1987) prototypic
descriptions of attachment patterns was employed to
assess children’s attachment styles. Descriptions given to
children included: (a) ‘‘I find it easy to become close
friends with other children. I trust them and I am
 A.M. Brown, S.P. Whiteside / Journal of Anxiety Disorders 22 (2008) 263–272
comfortable depending on them. I do not worry about
being abandoned or about another child getting too close
friends with me’’ (secure attachment), (b) ‘‘I am
uncomfortable to be close friends with other children.
I find it difficult to trust them completely, difficult to
depend on them. I get nervous when another child wants
to become close friends with me. Friends often come
more close to me than I want them to’’ (avoidant
attachment), and (c) ‘‘I often find that other children do
not want to get as close as I would like them to be. I am
often worried that my best friend doesn’t really like me
and wants to end our friendship. I prefer to do everything
together with my best friend. However, this desire
sometimes scares other children away’’ (ambivalent
attachment). Children were provided these descriptions
and instructed to choose the description that applied best
to them.
3. Results
3.1. Preliminary analyses
Prior to analyzing the main hypotheses of the present
study, several analyses were conducted to determine
whether child gender and age significantly related to
children’s perceived parental rearing, worry, and
attachment style. First, given the large age range
(i.e., 7–18 years old), statistical tests were conducted to
assess differences between younger children (7–12
years old, n = 30) and older children (13–18 years old,
n = 34). Specifically, results of t-tests revealed no age
differences for three of the four EMBU-C scales or for
the PSWQ-C total score; further, a chi-square test did
not reveal an age effect for children’s attachment style,
all p’s > .05. Not surprisingly, a t-test revealed a
Table 1
Means and standard deviations for PSWQ-C, EMBU-C, and attachment measure from Muris, Meesters, et al. (2000) and the present study
Muris et al., total (N = 159)
PSWQ-C total 14.65 (5.44)
EMBU-C
Anxious rearing 20.90
Overprotection 20.06
Emotional warmth 30.91
Rejection 14.70
Attachment styles
Secure 130 (81.8%)
Avoidant 8 (5.0%)
Ambivalent 21 (13.2%)
Note. Means for the EMBU-C from Muris et al. are averages of children’s reports of maternal and paternal parental rearing behaviors.
*
p < .05.
**
p < .001.
267
significant age difference for the EMBU-C over-
protective scale, with younger children reporting more
overprotective behaviors from parents than older
children, t(1, 62) = 4.03, p < .001. Second, with regard
to gender, no significant gender effects emerged in t-
tests assessing the EMBU-C scales and the PSWQ-C
total score or for the chi-square test assessing children’s
attachment style, all p’s > .05. Given that, with the
exception of the overprotective scale of the EMBU-C,
analyses did not yield child gender or age effects, these
factors were not included as covariates in further
analyses.
3.2. Group means
Single sample t-tests were conducted to compare the
means for the present study’s sample to those for the
sample in Muris, Meesters, et al. (2000) on the PSWQ-C
and the EMBU-C. As expected, a significant difference
emerged on the PSWQ-C, such that the mean for the
present study was significantly higher than that for the
community sample in Muris et al., t(1, 61) = 8.26,
p < .001. Prior to comparing means on the EMBU-C,
an average of the means for each of the subscales of the
EMBU-C in Muris et al. was calculated in order to
combine children’s separate reports of maternal and
paternal parenting behaviors. Using these averages,
results revealed significantly higher means for over-
protective parenting, t(1, 63) = 5.86, p < .001, anxious
rearing, t(1, 62) = 2.31, p < .05, and parental rejection,
t(1,63) = 2.05, p < .05, on the EMBU-C for the present
study as compared to those for the sample in Muris
et al.. No significant difference emerged for emotional
warmth across samples. See Table 1 for means and
standard deviations.
Present study, total (N = 65)
24.40 (9.15)**
22.56 (5.75)*
23.65 (4.83)**
32.34 (6.18)
15.89 (4.55)*
42 (70%)
8 (11.7%)
12 (18.3%)
268 A.M. Brown, S.P. Whiteside / Journal of Anxiety Disorders 22 (2008) 263–272

3.3. Parental rearing behaviors and worry ambivalently attached children, p < .01. Findings did not
yield significant differences between worry scores for
Pearson correlations were computed to examine the avoidantly and ambivalently attached children or for
relations between children’s perceived parental rearing securely and avoidantly attached children. See Table 3 for
behaviors and their level of worry. Results revealed a means.
significant correlation between children’s perceived
parental rejection and worry (r = .34, p < .01). Worry 3.5. Parental rearing behaviors, attachment status,
was not significantly related to any of the other three and worry
scales, although there were trends for perceived anxious
rearing (r = .23, p = .08) and overprotection (r = .21, To examine the relations between the two family
p = .10) to be positively related to children’s worry. environment factors, a series of one-way ANOVAs was
Taken together, this suggests that higher levels of conducted with attachment style as the between-group
rejection and, to a lesser degree, anxious rearing and factor and EMBU-C scales as the dependent variables
overprotection are associated with higher levels of (see Table 3 for means and standard deviations by
worry in clinically anxious children. See Table 2 for attachment style). Results indicated that the attachment
correlations. styles differed with respect to perceived parental
warmth, F(2, 58) = 3.34, p < .05, and anxious rearing,
3.4. Attachment style and worry F(2, 57) = 3.26, p < .05. More specifically, post-hoc
analyses with least significant differences criteria
Similar to Muris, Meesters, et al. (2000), more indicated that ambivalently attached children reported
children endorsed the secure attachment item than less parental warmth than securely attached children,
avoidant and ambivalent attachment items: (a) secure = p < .05. There also was a trend suggesting that
42 (70%, 30 boys, 12 girls), (b) avoidant = 7 (11.7%, 5 avoidantly attached children reported less parental
boys, 2 girls), and (c) ambivalent = 11 (18.3%, 7 boys, 4 warmth than securely attached children, p = .06.
girls). To examine the effect of attachment style on worry, Additionally, ambivalently attached children reported
a one-way ANOVA was conducted. Results yielded a more anxious rearing behaviors than both securely
significant main effect of attachment style, F(2, ( p < .05) and avoidantly attached children ( p < .05).
56) = 5.30, p < .01. Post-hoc analyses with least sig- No difference emerged between securely and avoi-
nificant differences criteria indicated that securely dantly attached children on reports of anxious rearing
attached children endorsed lower levels of worry than behaviors.
Finally, to determine the contributions of both family
Table 2 environment factors to children’s worry, a stepwise
Pearson correlations among PSWQ-C total score and EMBU-C scales regression analysis was conducted with EMBU-C
1 2 3 4 5 scales and attachment status (i.e., transformed into
1. PSWQ-C – .23 .21 .16 .34 *
dummy variable with secure attachment = 0 and
2. Anxious rearing – .61* .16 .09 avoidant/ambivalent attachment = 1) as predictors and
3. Overprotection – .34* .00 PSWQ-C as the dependent variable. Findings indicated
4. Emotional warmth – .58 * that parental rejection (b = .26, p < .05) and insecure
5. Rejection – attachment (b = .33, p < .01) explained modest but
*
p < .01. significant and separate proportions of the variance of
worry scores. See Table 4 for regression statistics.
Table 3
Means and standard deviations for EMBU-C and PSWQ-C by attach- Table 4
ment style Results of regression analysis with EMBU-C scales and attachment
status as predictors and PSWQ-C as the dependent variable
Secure Avoidant Ambivalent
a Dependent Predictors R R2 B (S.E.) b
PSWQ-C 22.02 (8.72) 27.57 (11.30) 31.18 (6.77)b
Anxious rearing 21.98 (6.30) a 19.86 (1.95) a 26.18 (4.77)b PSWQ-C 1. Insecure attachment 0.38 0.15 6.67 0.33**
Overprotection 23.76 (5.13) 20.86 (2.67) 24.82 (5.25) (2.47)
Emotional warmth 33.55 (6.01) a 28.71 (6.13) 28.82 (5.44)b 2. Parental rejection 0.46 0.21 0.53 0.26*
Rejection 15.36 (4.51) 17.57 (6.00) 17.64 (3.82) (0.25)
*
Note. Means in each row with different superscripts differ signifi- p < .05.
**
cantly, p < .05. p < .01.
 A.M. Brown, S.P. Whiteside / Journal of Anxiety Disorders 22 (2008) 263–272
4. Discussion
This study represents a clinical replication of the
study by Muris, Meesters, et al. (2000) to determine
whether relations between family environmental
factors (i.e., parental rearing, attachment style) and
children’s worry would be maintained among a
clinical sample of anxious children. Consistent with
findings by Muris et al. and with theories of child
development and psychopathology (e.g., Bowlby,
1973; Wood et al., 2003), results of the present
study implicate the contribution of family environ-
mental factors to children’s worry. Findings were
comparable to those of Muris et al., but specific
relations among variables differed slightly from their
community sample.
4.1. Parental rearing behaviors
As hypothesized, the results demonstrated associa-
tions between anxious children’s perceived parental
rearing behaviors and their level of worry. Overall,
findings were most evident for parental rejection,
such that children with anxiety disorders who
perceived higher levels of parental rejection reported
more worries. There also were marginal relations
between perceived anxious rearing and overprotec-
tion, on the one hand, and children’s worry, on the
other hand. Perceived emotional warmth was not
substantially associated with children’s worry. In
general, these findings are consistent with those of
Muris, Meesters, et al. (2000) who found that non-
anxious children who perceived parents as engaging
in more rejecting and anxious rearing reported higher
levels of worry. Results are also consistent with
numerous studies identifying significant relations
between parental rejection and anxiety (Gruner
et al., 1999; Moore et al., 2004; Alonso et al.,
2004) and between parental overprotection and
anxiety (Bogels & van Melick, 2004; Hudson &
Rapee, 2005; Muris, Meesters, & von Brakel, 2003).
The fact that only trends emerged for anxious rearing
and overprotection was somewhat surprising; how-
ever, this supports previous research suggesting that
parental criticism and negativity (i.e., rejection) may
play a more salient role in the development of
childhood anxiety disorders (e.g., Hudson & Rapee,
2001; Moore et al.). Thus, although parents of
anxious children may engage in anxious and over-
protective parenting, it may be that rejection is most
strongly associated with worry and childhood anxiety
disorders.
269
4.2. Attachment style
With regard to attachment style, findings partially
confirmed our hypotheses. In particular, it was
hypothesized that an insecure attachment style, either
avoidant or ambivalent, would be associated with higher
levels of worry compared to a secure attachment style.
While results revealed that children with secure
attachment reported less worry than children with
avoidant or ambivalent attachment, the difference was
only significant for the group with ambivalent attach-
ment. These findings differed from those in Muris
et al.’s study which revealed significantly higher worry
scores for both ambivalent and avoidant attachment
styles as compared to secure attachment. The lack of
significant difference between the secure and avoidant
attachment groups may have resulted from insufficient
power. Indeed, there was a limited number of children
who endorsed having an avoidant attachment style
(n = 7). However, as discussed by Warren et al. (1997),
it is also possible that avoidantly attached children
‘‘displace’’ their anxious feelings and, in turn, are less
aware of and less likely to report worries than
ambivalently attached children. Furthermore, it is
interesting to speculate that an ambivalent attachment
is more closely associated with worry and anxiety than
avoidant attachment. Indeed, in the study by Warren
et al., only ambivalent attachment during childhood and
not avoidant attachment was predictive of anxiety
disorders during adolescence. As discussed by Warren
et al. and consistent with attachment theory (Bowlby,
1973; Cassidy, 1995), children with ambivalent attach-
ment may be especially prone to worry and anxiety
problems as a result of the uncertainty about their
caregiver’s availability and ability to protect them in
times of trouble. Additionally, these children may worry
about their own ability to effectively cope with their
environment.
4.3. Parental rearing behaviors, attachment style,
and worry
Although it was hypothesized that insecure attach-
ment styles would be related to negative parental
rearing behaviors more than a secure attachment style,
findings demonstrated that only an ambivalent attach-
ment style, and not an avoidant attachment style, was
significantly related to children’s perceived parental
rearing behaviors. Specifically, ambivalently attached
children reported less parental emotional warmth as
compared to children who endorsed a secure attachment
style. Ambivalently attached children were also more
270 A.M. Brown, S.P. Whiteside / Journal of Anxiety Disorders 22 (2008) 263–272
likely to report more anxious rearing as compared to
children with either secure or avoidant attachment
styles. Again, this finding is consistent with attachment
research demonstrating that children with ambivalent
attachment, which is believed to result from incon-
sistent and intrusive parenting, perceive less emotional
support (e.g., Cassidy, 1995) and more anxiety
(Manassis, Bradley, Goldberg, Hood, & Swinson,
1994) in their relationship with their parent. A parent
who interacts with their child in inconsistent and
uncertain ways is not consistently meeting their child’s
emotional needs and may come across as less certain
and more anxious in the way they interact with their
child. Moreover, these parenting dimensions (i.e., high
anxious rearing and low emotional warmth) may have
actually contributed to the development of an ambiva-
lent attachment style in these children; however, the
cross-sectional nature of these data does not allow for a
conclusion regarding causality.
Interestingly, there were no differences between
perceived rearing behaviors for secure and avoidant
attachment styles. This is in contrast to the study by
Muris, Meesters, et al. (2000) who found avoidant
attachment to be associated with perceived parental
rejection. While findings from this study may have been
partly due to the limited number of children who endorsed
an avoidant attachment style, findings imply that an
ambivalent attachment style for anxious children is more
closely associated with negative parental rearing beha-
viors than either secure or avoidant attachment styles.
Finally, findings supported hypotheses that both
attachment and parental rearing are related to children’s
worry. In the present study, results of the regression
analysis indicated that the relative contribution of
parental rearing behaviors to children’s worry is largely
explained by parental rejection. Although studies have
highlighted other parenting behaviors, including anxious
and overprotective rearing, this finding is consistent with
the extensive research demonstrating the significance of
rejection to children’s anxious symptoms (Gruner et al.,
1999; Muris et al., 2003; Hudson & Rapee, 2001) and
provides further evidence that parental rejection plays an
important role in the development and maintenance of
childhood anxiety problems. Furthermore, the contribu-
tion of children’s attachment style was somewhat
stronger than that of parental rejection and explained a
separate and unique part of the variance. This is
consistent with past studies indicating that insecurely
attached children and adolescents are more likely to
report higher levels of anxiety and worry as compared to
their securely attached counterparts (Muris, Mayer, &
Meesters, 2000; Muris, Meesters, et al., 2000; Warren
et al., 1997). Moreover, our findings support those of
Warren et al. suggesting that insecure attachment has a
unique contribution to anxious symptoms. Overall,
findings propose an additive model where both parental
rejection and insecure attachment uniquely contribute to
children’s worry.
4.4. Limitations and future research directions
While the present study represents an important step
in evaluating family environmental factors, including
children’s attachment and perceived parental rearing
behaviors, among a clinical sample of anxious children,
several limitations exist. To begin with, the study relied
on child report and lacked observational and parent report
data. These methods of assessment would have provided
excellent comparisons to evaluate whether children’s
expectations of parental rearing behaviors are similar to
those observed clinically and reported by parents.
Additionally, relying solely on child report data provided
a potential source of measurement error due to rater bias.
Given that the same respondent provided information on
all variables, it is possible that the magnitude of
associations was inflated because of shared method
variance. Children’s responses also may have been
influenced by their current anxious symptoms. Thus,
future studies would benefit from using a multiple
informants approach (e.g., Bogels & van Melick, 2004)
to reduce the likelihood of these potential sources of
error. Another limitation pertains to the attachment
measure used. As stated in the study by Muris, Meesters,
et al. (2000), use of a single-item instrument to assess
children’s attachment may have resulted in an under-
estimate of children’s attachment styles. Future research
would benefit from utilizing a more sophisticated
assessment of children’s attachment. Finally, given that
Muris et al. studied a Dutch sample, there are probable
cultural differences that limit conclusions that can be
drawn from comparing our samples. Although differ-
ences were in the expected directions, we can only
speculate about the ability of the EMBU-C to
differentiate between parents of anxious and non-anxious
children. In addition, although the current study provides
initial support for using the EMBU-C to describe parents
in general, rather than each independently, the difference
in instructions between the two studies limits the
comparability of the results. Further, using the EMBU-
C to describe parents in general may neglect important
differences between mothers and fathers. Thus, future
studies should examine the value of combining mother
and father information versus providing separate ratings
for each parent.
 A.M. Brown, S.P. Whiteside / Journal of Anxiety Disorders 22 (2008) 263–272
A primary objective of the present study was to
evaluate the use of the EMBU-C with a clinical sample
of anxious children. While these findings provide an
initial exploration, further research is warranted. First,
research is needed to establish North American norms
for the EMBU-C. Without norms, we are unable to
deduce the significance of the scores in the present
study. Second, research is needed to establish the
validity of the EMBU-C. At this point, it is uncertain
whether the EMBU-C provides a valid reflection of
parenting styles. To this end, the next stage of research
should involve evaluating the ability of the EMBU-C to
differentiate between parents of anxious and non-
anxious children, in addition to comparing competent
parents to those who may be more likely to exhibit poor
parenting behaviors (e.g., parents referred to the county
for neglect or physical abuse reasons). Additionally,
research should assess the extent to which the EMBU-C
relates to other measures of parenting or family
functioning to establish concurrent and divergent
validity (e.g., parent report questionnaires, observa-
tional assessment strategies). Finally, treatment out-
come research for parent interventions that compares
findings of the EMBU-C before and after treatment
would also assist in our understanding of the clinical
utility of the EMBU-C.
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