Psychosocial and biological risk factors of anxiety disorders in adolescents: a TRAILS report

Altanzul Narmandakh,Albertine J Oldehinkel,Annelieke M Roest,Peter De Jonge

doi:10.1007/s00787-020-01669-3

Altanzul Narmandakh, Albertine J Oldehinkel + Show 2 more

Open Access

https://doi.org/10.1007/s00787-020-01669-3

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Abstract

Anxiety disorders are a common problem in adolescent mental health. Previous studies have investigated only a limited number of risk factors for the development of anxiety disorders concurrently. By investigating multiple factors simultaneously, a more complete understanding of the etiology of anxiety disorders can be reached. Therefore, we assessed preadolescent socio-demographic, familial, psychosocial, and biological factors and their association with the onset of anxiety disorders in adolescence. This study was conducted among 1584 Dutch participants of the TRacking Adolescents’ Individual Lives Survey (TRAILS). Potential risk factors were assessed at baseline (age 10–12), and included socio-demographic (sex, socioeconomic status), familial (parental anxiety and depression), psychosocial (childhood adversity, temperament), and biological (body mass index, heart rate, blood pressure, cortisol) variables. Anxiety disorders were assessed at about age 19 years through the Composite International Diagnostic Interview (CIDI). Univariate and multivariate logistic regression analyses were performed with onset of anxiety disorder as a dependent variable and the above-mentioned putative risk factors as predictors. Of the total sample, 25.7% had a lifetime diagnosis of anxiety disorder at age 19 years. Anxiety disorders were twice as prevalent in girls as in boys. Multivariate logistic regression analysis showed that being female (OR = 2.38, p < .01), parental depression and anxiety (OR = 1.34, p = .04), temperamental frustration (OR = 1.31, p = .02) and low effortful control (OR = 0.76, p = .01) independently predicted anxiety disorders. We found no associations between biological factors and anxiety disorder. After exclusion of adolescents with an onset of anxiety disorder before age 12 years, being female was the only significant predictor of anxiety disorder. Being female was the strongest predictor for the onset of anxiety disorder. Psychological and parental psychopathology factors increased the risk of diagnosis of anxiety, but to a lesser extent. Biological factors (heart rate, blood pressure, cortisol, and BMI), at least as measured in the present study, are unlikely to be useful tools for anxiety prevention and intervention strategies.

Highlights

Anxiety disorders are the most common group of mental disorders worldwide [1], and the sixth leading cause of disability worldwide according to the Global Burden of Disease Study [2]
We investigated independent risk factors in pre-adolescence (11 years) for anxiety disorders in late adolescence (19 years) using a wide range of factors and a large community sample
We explored whether predictors differ for various anxiety disorders

Summary

Introduction

Anxiety disorders are the most common group of mental disorders worldwide [1], and the sixth leading cause of disability worldwide according to the Global Burden of Disease Study [2]. Most adolescents with anxiety disorders do not receive mental health treatments for their symptoms [7]. This is a reason for concern, because untreated adolescent anxiety disorders tend to persist for a long time, with severe consequences [8,9,10]. Adolescent anxiety disorders have multifactorial causes, and tend to cluster in specific subgroups

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