Date of Award

January 2023

Document Type


Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Sarah R. Lowe


Background: Anxiety disorders are the most common psychological disorder in children and can have profound impacts on development. Prior research suggests the importance of risk factors for child anxiety related to parenting, including parenting stress and psychological control. Parenting stress refers to any distress experienced by a parent in relation to caring for their child; and psychological control refers to a parent attempting to manipulate a child’s thoughts, emotions and feelings to exert control. Greater clarity is needed for how these parenting factors relate to each other in shaping child anxiety, however. The interaction between parenting stress and psychological control in shaping child anxiety in a clinically referred sample has not been explicitly tested to our knowledge. Researchers have also not fully considered the role of race and ethnicity in the pathway from parenting stress to child anxiety. Prior research indicates that racial and ethnic minorities are at heightened risk for parenting stress, and parenting styles differ across race, ethnicity, and cultures. This study examined the relationships among parenting stress, psychological control, and child anxiety, and assessed whether these relationships were moderated by race.

Methods: Parents (N=474; mean child age=9.31, SD=2.66 years) were recruited as part of a child anxiety clinical trial and completed a battery of questionnaires after signing informed consent and assent. In this study, maternal psychological control was assessed with the Parent Report of the Parental Behavior Inventory (PRPBI). Child anxiety was assessed with the parent report of the Multidimensional Anxiety Scale for Children (MASC), and parenting stress with the parent report of Parenting Stress Index-4 (PSI-4). These measures have satisfactory psychometric properties and are widely used in child anxiety and parenting research. Demographics were collected via self-report information sheets.

Results: Results from Pearson bivariate correlations showed that parenting stress was significantly correlated with child anxiety (r=0.28; p<0.001) and psychological control (r=0.38; p<0.001). A positive trend was detected in the association between child anxiety and psychological control, however, this trend was not statistically significant (r=0.08; p=0.069). One-Way analysis of variance showed that Asian parents reported significantly higher psychological control than Black or African American parents (mean diff=2.63±0.934; p=0.31), White parents (mean diff=3.46±0.660; p<0.001), and Multiracial parents (mean diff=2.99±0.934; p=0.009). Results from multivariable regression analyses revealed that parenting stress was significantly predictive of psychological control (standardized β=0.35; p<0.001) and child anxiety (standardized β=0.28; p<0.001). Results from moderation analyses found that race did not moderate the relationship between parenting stress and psychological control; however, it did act as a moderator when child anxiety was the outcome. The effect of parenting stress on child anxiety was lower for White participants versus Asian participants (b=-0.77; SE=0.33; p=0.019).

Conclusion: Our findings agree with previous literature supporting relationships between parenting stress and child anxiety and psychological control. As parenting stress increased, both psychological control and child anxiety increased. Results suggest that racial and cultural differences may influence parenting styles, parenting stress, and child outcomes. Limitations are the very small sub-race categories and the inability to make any valid conclusions based on race or regarding directionality or causality.


This thesis is restricted to Yale network users only. It will be made publicly available on 05/10/2025