Objective: Research on family accommodation is burgeoning, implicating it in the development, maintenance, and treatment of childhood anxiety. Additional data are needed to guide theory development and clinical application in this area. The factors underlying family accommodation measures have never been confirmed, nor have any test-retest data been reported. The study's objectives were to provide confirmatory data of the factorial structure and the first test-retest reliability data on the most widely used measure of family accommodation of child anxiety, the Family Accommodation Scale - Anxiety (FASA), and the child-rated FASA-CR.
Method: Participants were 331 children (51% female; mean age = 10.44 yrs, SD = 2.95; 84.6% White) and their parent, presenting consecutively to an anxiety disorders program. Exploratory factor analysis (EFA) was conducted first on a random sampling of 105 child-parent dyads; factors were confirmed with confirmatory factor analysis (CFA) in the remaining independent sample of 226 dyads. Test-retest reliability (mean retest interval = 10 days) was examined for FASA and FASA-CR. Convergent validity was examined in relation to child anxiety symptoms, and parenting stress. Divergent validity was examined in relation to child depression symptoms.
Results: EFA and CFA supported a two-factor model of family accommodation, representing Participation in child-anxiety-driven behaviors, and child-anxiety-related Modification of family routines and schedules. Test-retest reliability was satisfactory for parents and adolescents; less so for children aged 6 to 12 years.
Conclusions: Family accommodation is a key construct in childhood anxiety, with two underlying factors that can be validly and reliably assessed using FASA and FASA-CR.