Quấy rầy mối quan hệ chăm sóc thường là một trong những tính năng bệnh nguyên, cùng với các yếu tố nguy cơ khác, góp phần vào sự phát triển của các rối loạn lâm sàng. Trong ánh sáng của những, người ta có thể tranh luận rằng phản ứng của cha mẹ để sự sợ hãi phát triển | PHOBIAS IN CHILDREN AND ADOLESCENTS COMMENTARIES 291 attachment theory in the origin maintenance and remediation of anxiety disorders social withdrawal and inhibition childhood depression and conduct disorders. Disturbed caregiving relationships are often one of the etiologic features that together with other risk factors contribute to the development of these clinical disorders. In the light of these one may argue that the parent s reaction to the developmental fear may be one of the factors that determine whether a developmental fear will become a phobia. Parental communication that focuses on the phobic symptom and their concern reinforcement of dependent and anxious behaviour in the attachment relationship and maternal anxiety could then impact as mediating factors. Ollendick et al. s review emphasizes the role of the perception more than the actual experience of the stimulus as potentially harmful. No need to say that the younger the child is the more he she is dependent on the parental perception of the environment. In spite of these sound theoretical arguments no study to our best knowledge has specifically looked at the link between the development of phobias and the security of attachment of young children. Interestingly enough Shear 6 has provided a potential model of the role of attachment in the development of both agoraphobia and panic in adults though. While waiting for such a study with young phobic children Ollendick et al. s report of a study comparing systematic desensitization psychotherapy and waiting list control may give us a hint about the role of the parental impact on their young child s phobic disorder contrary to the authors expectations the two treatments were found equally effective in reducing phobic behaviours Their explanation lay in the fact that parents in both groups received training to help manage the children s behaviour or in more psychodynamic terms to contain their child s anxiety while exposing them to the feared stimulus.
