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Background: Given the robust evidence base for the efficacy of evidence‐based treatments targeting youth anxiety, researchers have advanced beyond efficacy outcome analysis to identify mechanisms of change and treatment directionality. Grounded in developmental transactional models, interventions for young children at risk for anxiety by virtue of behaviorally inhibited temperament often target parenting and child factors implicated in the early emergence and maintenance of anxiety. In particular, overcontrolling parenting moderates risk for anxiety among highly inhibited children, just as child inhibition has been shown to elicit overcontrolling parenting. Although longitudinal research has elucidated the temporal unfolding of factors that interact to place inhibited children at risk for anxiety, reciprocal transactions between these child and parent factors in the context of early interventions remain unknown. Method: This study addresses these gaps by examining mechanisms of change and treatment directionality (i.e., parent‐to‐child vs. child‐to‐parent influences) within a randomized controlled trial comparing two interventions for inhibited preschoolers (N = 151): the multicomponent Turtle Program ('Turtle') and the parent‐only Cool Little Kids program ('CLK'). Reciprocal relations between parent‐reported child anxiety, observed parenting, and parent‐reported accommodation of child anxiety were examined across four timepoints: pre‐, mid‐, and post‐treatment, and one‐year follow‐up (NCT02308826). Results: Hypotheses were tested via latent curve models with structured residuals (LCM‐SR) and latent change score (LCS) models. LCM‐SR results were consistent with the child‐to‐parent influences found in previous research on cognitive behavioral therapy (CBT) for older anxious youth, but only emerged in Turtle. LCS analyses revealed bidirectional effects of changes in parent accommodation and child anxiety during and after intervention, but only in Turtle. Conclusion: Our findings coincide with developmental transactional models, suggesting that the development of child anxiety may result from child‐to‐parent influences rather than the reverse, and highlight the importance of targeting parent and child factors simultaneously in early interventions for young, inhibited children. [ABSTRACT FROM AUTHOR]

This pilot study of 23 mothers with attention-deficit/hyperactivity disorder (ADHD) and their offspring with ADHD examined the effects of maternal stimulant medication on observed interactions. Parent-child interactions were observed using a structured protocol before and after mothers underwent a 5-week, double-blind stimulant titration. Despite dramatic effects of medication on adult ADHD symptoms, this small pilot and open label laboratory-based study did not identify maternal stimulant effects on observed parenting or child behavior. Given the documented impairments in parenting displayed by adults with ADHD, behavioral parenting interventions may be needed in conjunction with medication for mothers with ADHD to optimize family outcomes. [ABSTRACT FROM AUTHOR]