The development and maintenance of anxiety symptoms from infancy through adolescence in a longitudinal sample

TLDR

The study examined the etiology and course of anxiety symptoms from infancy through adolescence in a high‑risk community sample. The study assessed 155 participants with observational, projective, and objective measures across development. Path analyses showed that anxiety symptoms are moderately stable, with neonatal reactivity and attachment predicting later regulation and peer problems that lead to anxiety, and that the developmental model specifically predicts anxiety rather than general psychopathology. Funding was provided by the National Institute of Mental Health, William T.

Abstract

This study examined the etiology and course of anxiety symptoms from infancy through adolescence in a longitudinal high-risk community sample. One hundred fifty-five subjects were assessed using a variety of observational, projective, and objective measures. Results of path analyses revealed the following: (a) anxiety symptoms showed moderate stability during childhood and adolescence; (b) heightened neonatal biobehavioral reactivity and poor regulation predicted emotion regulation difficulties in preschool, which predicted anxiety symptoms in childhood; (c) developmental incompetence in childhood predicted anxiety symptoms in preadolescence, and anxiety symptoms in preadolescence predicted incompetence in adolescence; (d) insecure attachment relationships in infancy predicted negative peer relationship representations in preadolescence, and these representations predicted anxiety symptoms in adolescence; (e) compared to males, females showed similar rates of anxiety symptoms in childhood but greater and more stable rates in adolescence; however, males and females showed similar patterns of association between risk factors and anxiety symptoms across childhood and adolescence; and (f) the model tested was specific in predicting anxiety symptoms and not psychopathology in general. The results support a developmental model of the etiology and maintenance of anxiety symptoms in childhood and highlight factors to consider in efforts to prevent and treat childhood anxiety.This article is based on a doctoral dissertation completed by the first author. The research was supported by a Philanthropic Educational Organization Scholarship to the first author and by funds provided by grants to the second author from the Maternal and Child Health Service (MC-R-270416); the William T. Grant Foundation, New York; and the National Institute of Mental Health (MH-40864). This study is currently supported by the National Institute of Mental Health (MH-40864-18). The authors thank Manfred van Dulmen for the invaluable statistical guidance he provided in the preparation of this manuscript and the families and teachers whose generation donation of time made this project possible.