# Parent interpretation bias as a key mechanism of intergenerational transmission of anxiety

> **NIH NIH R01** · MCLEAN HOSPITAL · 2024 · $111,618

## Abstract

Approximately 30% of children will experience an anxiety disorder, making anxiety the most common
mental health problem among children in the United States. However, few children receive treatment and
even our most effective anxiety treatments leave up to half of children in need of additional intervention.
Despite the well-established role of parent anxiety in transmitting and maintaining child anxiety, the lack of
data on specific parent mechanisms underlying the intergenerational transmission of anxiety is a critical
barrier to informing novel targets of personalized treatments. Consistent with NIMH’s Strategic Plan,
Objective 2.2 to understand risk factors and behavioral indicators of mental illness across the lifespan and
to identify novel intervention targets based on knowledge of psychological mechanisms, the current
proposal focuses on interpretation bias, the tendency to perceive threat in ambiguous situations. The
overall objective of this project is to empirically test a theoretical model of the intergenerational
transmission of anxiety focused on parent interpretation bias as a root cause. Our specific aims are to test
theorized effects of parent interpretation bias on (1) parent behavior and (2) child interpretation bias and
(3) evaluate potential moderators to refine theories of intergenerational transmission of anxiety and inform
future personalized interventions. Our central hypothesis is that parent interpretation bias influences child
interpretation bias through its effects on maladaptive, anxiety-promoting parenting behaviors, such as
accommodation and modeling of avoidant coping. To test this hypothesis, we will randomize 300 parents
of children ages 7-12 to complete four weeks of a smartphone delivered interpretation bias manipulation
vs. a self-assessment smartphone app condition. The interpretation bias intervention teaches parents to
interpret ambiguous situations in a non-threatening manner via quick, repeated practice and corrective
feedback. Before and after completing their randomly assigned condition, parent-child dyads will complete
self-report and behavioral tasks designed to elicit anxiety-promoting behaviors from parents depending
upon their interpretation of the ambiguous situation (speech and puzzle tasks). Parents will also complete
Ecological Momentary Assessment (EMA) of parenting behaviors to capture the time course of effects.
Finally, we will examine downstream effects of the interpretation manipulation on child interpretation bias
at pre- and post- visits. We will test moderators (e.g., parent anxiety and gender) to refine theories of
intergenerational transmission of anxiety and inform future personalized interventions. The long-term goal
of this work is to inform personalized, mechanism-focused interventions to improve mental health
outcomes for anxious children and their parents. Future studies will translate knowledge gained from this
project into a scalable treatment that can be implemented entirely ...

## Key facts

- **NIH application ID:** 11001075
- **Project number:** 3R01MH129374-02S1
- **Recipient organization:** MCLEAN HOSPITAL
- **Principal Investigator:** Courtney Beard Elias
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $111,618
- **Award type:** 3
- **Project period:** 2023-02-01 → 2028-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11001075

## Citation

> US National Institutes of Health, RePORTER application 11001075, Parent interpretation bias as a key mechanism of intergenerational transmission of anxiety (3R01MH129374-02S1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/11001075. Licensed CC0.

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