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Early childhood anxiety disorders: continuity and predictors in adolescence

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Abstract

Anxiety disorders are among the most common disorders in early childhood. Although many older children and adolescents with anxiety disorders recover and remain well, little is known about the continuity of early childhood anxiety and the factors that predict persistence/recurrence in later childhood and adolescence. We followed 129 children who met anxiety disorder criteria at age 3 and/or 6 and determined how many continued to experience an anxiety disorder between age 7 and 15, as well as the continuity of specific anxiety disorders. We explored whether biological sex, number of anxiety disorders, early childhood persistence (i.e., anxiety diagnosis at both age 3 and 6), childhood comorbidities, temperamental behavioral inhibition, a maternal history of anxiety, and authoritarian and overprotective parenting predicted persistence/recurrence of an anxiety disorder from age 7 to 15. Sixty-five (50.4%) of the adolescents with an early childhood anxiety disorder met anxiety disorder criteria during the age 7–15 interval. Homotypic continuity from early childhood to school-age/mid-adolescence was observed for social anxiety disorder, separation anxiety disorder, and generalized anxiety disorder (GAD). Early childhood agoraphobia predicted school-age/mid-adolescent GAD and early childhood GAD predicted school-age/mid-adolescent specific phobia. In bivariate analyses, number of anxiety disorders, persistence of anxiety from age 3 to 6, and having a mother with a history of anxiety predicted the persistence/recurrence of anxiety disorders from age 7 to 15. Only early childhood persistence of anxiety uniquely predicted the persistence/recurrence of an anxiety disorder over and above the other predictors. Early intervention efforts should focus on identifying and intervening with young children who demonstrate a protracted course of anxiety.

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Funding

This work was supported by NIMH Grant R01-MH069942 (Klein).

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Authors and Affiliations

  1. Department of Psychology, Stony Brook University, Stony Brook, NY, 11790-2500, USA

    Alexander Grieshaber, Jamilah Silver & Daniel N. Klein

  2. Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, USA

    Sara J. Bufferd

  3. Department of Psychology, University of Maryland, College Park, MD, USA

    Lea Dougherty

  4. Department of Psychiatry and Behavioral Health, Stony Brook University, Stony Brook, NY, USA

    Gabrielle Carlson

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  1. Alexander Grieshaber
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  2. Jamilah Silver
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  3. Sara J. Bufferd
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  4. Lea Dougherty
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  6. Daniel N. Klein
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by DNK, SJB, LD, AG, and JS. The first draft of the manuscript was written by AG and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Alexander Grieshaber.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethics approval

The Stony Brook University Institutional Review Board approved the procedures for the current study.

Consent to participate

Parents provided written informed consent at each wave of the study (age 3, 6, 9, 12, and 15). At age 12 and 15, participants also provided written informed assent. Families received compensation for their participation at each wave of the study.

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Grieshaber, A., Silver, J., Bufferd, S.J. et al. Early childhood anxiety disorders: continuity and predictors in adolescence. Eur Child Adolesc Psychiatry (2023). https://doi.org/10.1007/s00787-023-02287-5

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