Worry Content Research Articles

Asthma and anxiety in children and adolescents: characteristics and treatment outcomes

Objective This study (a) examined anxious youth with and without asthma on measures of negative self-talk, parental psychopathology, worry content, physical symptoms, panic symptoms, generalized symptoms, and separation anxiety symptoms, and (b) tested if outpatient CBT or medication were differentially effective in reducing anxiety for youth with asthma and anxiety. Methods This secondary analysis separated youth with an anxiety disorder into asthma and non-asthma groups. Youth were also compared on response to treatments (i.e. CBT, sertraline, combined, and placebo). Results A total of 488 participants participated in the original study, with an average age of 10 years (SD 2.87). Youth with comorbid asthma and anxiety demonstrated higher rates of negative self-talk. Youth with comorbid asthma and anxiety did not differ from the non-asthma group on measures of physical symptoms, anxiety disorder specific symptoms, parental psychopathology, or worry content. Youth with asthma and anxiety responded similarly to the non-asthma group to treatment across treatment conditions. Conclusions Treatment was comparably effective for youth with comorbid asthma and anxiety and youth with anxiety. Future research could examine the effects of psychopharmaceuticals on asthma and anxiety comorbidity.

CBT for Generalized Anxiety Disorder in Parkinson’s Disease: A Case Study

ABSTRACT Objectives To examine the use of cognitive behavioral therapy (CBT) in a case of co-occurring generalized anxiety disorder (GAD) and Parkinson’s disease (PD). Methods This case study refers to a male aged 75 years with a diagnosis of Idiopathic Parkinson’s disease. It focuses on applying a CBT model to address the psychological difficulties with PD and GAD. Results This case study reveals key aspects in presentation, diagnosis, and psychological treatment between PD and GAD, and is one of few studies published in this area. Conclusions Symptoms of anxiety in an older adult with PD decreased during a course of CBT. The implications of the treatment outcome of this study and further considerations of treatment plans for comorbid PD and anxiety have been discussed. Clinical Implications Using CBT could positively impact non-motor symptoms of Parkinson’s, such as sleep difficulties and speech impediments. Using CBT for the catastrophic thinking and worry content in GAD seems to act as a complementary therapy for psychological/non-motor symptoms of PD.

The predictive role of intolerance of uncertainty and trait of worry in breast cancer patients: A prospective, observational, single-center clinical study.

Breast cancer diagnosis and treatment compromise well-being in a pervasive way, and negative consequences may remain after recovery. The psychological side of breast cancer has been extensively investigated; however, the role of intrusive thoughts and intolerance of uncertainty have been studied less systematically. The present study aimed to prospectively evaluate worry content, depression, anxiety, and post-traumatic stress symptoms and to define the role of the trait of worry and intolerance of uncertainty (IU) related to breast cancer. Patients with their first breast cancer diagnosis were enrolled in a single-center, prospective observational trial. The trait of worry and IU were assessed using the Penn State Worry Questionnaire (PSWQ) and the Intolerance of Uncertainty Scale-Revised (IUS-R). The psychological aspects were evaluated using the Worry Domains Questionnaire (WDQ), the Beck Anxiety (BAI), Beck Depression Inventory-II (BDI-II), and the Impact of Event Scale-Revised (IES-R). Questionnaires were administered in a randomized sequence at diagnosis (T0), 3 months post-diagnosis (T1), and 12 months post-diagnosis (T2). One hundred and fifty eligible patients were enrolled in the study and provided the T0 assessment. Further compliance rates were 57% at T1 and 64% at T2. All patients showed a significant and continuous increase in the IES-R scale (p < 0.0001) from diagnosis to the end of the study, while no significant changes were observed for the WDQ, BAI, and BDI-II scales. The clinical PSWQ levels and/or high levels of the IUS-R score were the only variables that aided the distinction between patients who maintain high levels of depression, anxiety, and post-traumatic disorders and those who did not. An early assessment of the components of the trait of worry and intolerance of uncertainty could be critical in identifying patients with a higher psychopathological risk. Furthermore, if future studies confirm the present findings, support and monitoring throughout the prognosis may present crucial benefits, and possibly affect the course of treatment.

Interconnectivity of fear of progression and generalized anxiety – Network analysis among a sample of hematological cancer survivors

PurposeFear of cancer progression and recurrence (FoP) and generalized anxiety disorder (GAD) are syndromes commonly seen in cancer patients. This study applied network analysis to investigate how symptoms of both concepts are interconnected.MethodsWe used cross-sectional data from hematological cancer survivors. A regularized Gaussian graphical model including symptoms of FoP (FoP-Q) and GAD (GAD-7) was estimated. We investigated (i) the overall network structure and (ii) tested on pre-selected items whether both syndromes could be differentiated based on their worry content (cancer related vs. generalized). For this purpose, we applied a metric named bridge expected influence (BEI). Lower values mean that an item is only weakly connected with the items of the other syndrome, which can be an indication of its distinctive characteristic.ResultsOut of 2001 eligible hematological cancer survivors, 922 (46%) participated. The mean age was 64 years and 53% were female. The mean partial correlation within each construct (GAD: r = .13; FoP: r = .07) was greater than between both (r = .01). BEI values among items supposed to discriminate between the constructs (e.g., worry about many things within GAD and fear not to endure treatment within FoP) were among the smallest so our assumptions were confirmed.ConclusionsOur findings based on the network analysis support the hypothesis that FoP and GAD are different concepts within oncology. Our exploratory data needs to be validated in future longitudinal studies.

The Relationship between COVID-19 Protection Behaviors and Pandemic-Related Knowledge, Perceptions, Worry Content, and Public Trust in a Turkish Sample.

This study aimed to explore the effect of knowledge, COVID-19-related perceptions, and public trust on protective behaviors in Turkish people. Data were collected from an online survey (Turkish COVID-19 Snapshot Monitoring) conducted between July 2020 and January 2021. The recommended protective behaviors (hand cleaning, wearing a face mask, and physical distancing) to prevent COVID-19 were examined. The impacts of the following variables on protective behaviors were investigated using logistic regression analysis: knowledge, cognitive and affective risk perception, pandemic-related worry content, public trust, conspiracy thinking, and COVID-19 vaccine willingness. Out of a total of 4210 adult respondents, 13.8% reported nonadherence to protection behavior, and 86.2% reported full adherence. Males and young (aged 18-30 years) people tend to show less adherence. Perceived self-efficacy, susceptibility, and correct knowledge were positively related to more adherence to protective behavior. Perceptual and emotional factors explaining protective behavior were perceived proximity, stress level, and worrying about the relatives who depended on them. Trust in health professionals and vaccine willingness were positive predictors, while conspiracy thinking and acquiring less information (&lt;2, daily) were negative predictors. Unexpectedly, trust in the Ministry of Health showed a weak but negative association with protection behavior. Perceived stress, altruistic worries, and public trust seem to shape protection behaviors in addition to individuals' knowledge and cognitive risk perception in respondents. Males and young people may have a greater risk for nonadherence. Reliable, transparent, and culture-specific health communication that considers these issues is required.

High-frequency variability in heart rate is related to COVID-19-associated worries six years later

Elevated resting heart rate variability (HRV) in the high frequency range has been proposed to be protective against worrying when facing environmental stressors. Yet, prospective studies using real-life stressors are still scarce.The present study set out to replicate the previous finding of reduced resting HRV predicting COVID-19-associated worries in a larger, more homogenous sample over a longer period of time (N = 123; age: 42.32 [SD:10.72]; 65.9 % female; average time lag: six years). In addition, we were interested in investigating the specificity of this effect with respect to worry content, other physiological markers of autonomic functions, and additional potentially relevant covariates with a special focus on a potential moderating effect of sex on this association.In regression analyses adjusting for age, sex, BMI and smoking status, the interaction between HRV and sex was significant, with women depicting a stronger association between HRV and COVID-19 associated worries. Further sensitivity analyses revealed the specificity of the effect for HRV as distinct from mean heart rate, as well as its dependence on previous COVID-19 infection, but not COVID-19 vaccination status and chronic stress level.These data are in line with theories that propose that higher HRV levels can be protective against the deleterious effects of real-life environmental stressors. However, our results also point to the specificity of this effect, especially with respect to worry content and sex.

Thinking of Me or Thinking of You? Behavioral Correlates of Self vs. Other Centered Worry and Reappraisal in Late-Life.

Psychotherapeutic approaches in late-life anxiety have limited effect on reducing worry severity. The self-referential processing of worry contents (self- vs. other-focused worry) and reappraisal styles (internal vs. external locus of control) are important elements in psychotherapy, but little is known about these processes in late-life. We aimed to characterize severe worry from a self-referential processing perspective. We recruited 104 older adults with various levels of worry and used a personalized task to induce and reappraise worry. We analyzed the association between (1) worry severity/frequency for worry content (self- or other-focused) and (2) for reappraisal style (internal vs. external locus of control) with clinical inventories measuring anxiety, worry, depression, rumination, neuroticism, emotion regulation strategies, perceived stress, and physical illness burden. Higher self-worry severity was associated with higher scores of clinical inventories of worry, depression, perceived stress, and neuroticism, whereas other-worry severity did not show any association. Greater self-worry frequency was associated with higher medical burden. External locus of control in reappraisal statements was associated with lower worry severity in men. Overall, more severe and frequent self-focused worry was associated with a greater psychological and physiological burden. These results are useful in tailoring psychotherapy for older adults with severe worry.

Changing Metacognitive Appraisal Bias in High-Worriers Through Reappraisal Training

Background and ObjectivesWorry-related negative metacognitive beliefs about worrying maintain and predict pathological worry. For the current proof-of-principle study, we developed a computerized cognitive bias modification based—reappraisal training (RT), to modify the appraisal of negative metacognitive beliefs in a high-worrying sample. A functional and dysfunctional RT were pitted against each other to investigate whether appraisals of one’s thinking and coping changed following training. Moreover, training effects on the number of negative thoughts and interpretations of the worry content were examined.MethodsParticipants (N = 81) were trained to adopt a functional (disconfirmation of negative metacognitive beliefs) or dysfunctional (confirmation of negative metacognitive beliefs) appraisal style using a series of vignettes that had to be completed in line with the intended training direction. Changes in negative thoughts from pre- to post-RT were assessed with a behavioral state worry task, and transfer to interpretations with an open-ended stem sentence task.ResultsFindings support the use of the RT to alter a metacognitive appraisal bias, as participants receiving the functional RT reported fewer negative appraisals of one’s thinking and coping than participants in the dysfunctional RT group. Number of negative thoughts and interpretations were not directly affected by training.LimitationsThis study employed an analog sample and future research should replicate findings in a clinical sample for which negative metacognitions are more relevant.ConclusionsThese findings highlight the potential of metacognitive RT for future translational studies with (clinical) samples characterized by repetitive negative thinking and/or negative metacognitive beliefs.

Characterizing worry content and impact in pregnant and postpartum women with anxiety disorders during COVID-19.

The novel COVID pandemic has had a substantial impact on global mental health, including those populations that are inherently vulnerable such as pregnant and postpartum (perinatal) women. Anxiety disorders (ADs) are the most common mental health disorders during the perinatal period, affecting up to one in five women. However, since the onset of the pandemic, up to 60% of perinatal women are experiencing moderate to severe levels of anxiety. Given the substantial increase in perinatal anxiety during COVID, we sought to better understand its phenomenology by characterizing the collective worry content and impact of COVID using a content analysis. Eighty-four treatment-seeking pregnant (n = 35) and postpartum (n = 49) women with a principal AD, participated in this study between April and October 2020. In addition to completing questionnaire measures and a semistructured diagnostic interview, participants were asked to (1) describe their top excessive and uncontrollable worries, (2) describe additional COVID and non-COVID worries, and (3) describe how the pandemic had affected their lives. All responses were given verbally and transcribed verbatim by assessors. A content analysis led to the emergence of various COVID and non-COVID worry and impact themes. One third of participant's principal worries were specific to COVID, and 40% of COVID worries were specific to the perinatal context. Understanding the worry content and impact of COVID may improve symptom detection and inform the development of targeted treatment strategies to support the mental health needs of perinatal women with ADs throughout the pandemic and thereafter. Understanding pandemic-specific worries is important for perinatal symptom screening and may allow for the development of targeted treatment strategies to address COVID-specific worries and impact.

Evaluation of an Augmented Cognitive Behavioural Group Therapy for Perinatal Generalized Anxiety Disorder (GAD) during the COVID-19 Pandemic.

The perinatal period is considered a window of vulnerability given the increased risk of psychiatric difficulties during this time, such as mood and anxiety disorders (ADs). Pre-pandemic rates of ADs in perinatal women were one in five but have since increased with the onset of the COVID-19 pandemic (COVID). In addition, recent research suggests that the focus of worry has shifted during the pandemic, with perinatal women reporting significantly more COVID-specific worries. The objective of this study was to augment our current evidence-based Cognitive Behavioural Group Therapy (CBGT) for perinatal anxiety protocol by targeting intolerance of uncertainty and tailoring existing strategies to address COVID-related worry and impact. Pregnant (n = 19) and postpartum (n = 49) women were recruited from regular clinic patient flow from a university-affiliated teaching hospital between September 2020 and March 2021. Improvements in generalized anxiety symptoms, worry, intolerance of uncertainty, and mood were observed at post-treatment, maintained at 3-months, and the intervention received high ratings of treatment satisfaction. This is the first study to examine an augmented CBGT for perinatal women with GAD during the pandemic and supports the inclusion of strategies that target intolerance of uncertainty as well as specific pandemic and perinatal worry content for effective outcomes.

Beliefs About Worry and Pain Amongst Adolescents With and Without Chronic Pain.

To explore beliefs about worries, beliefs about pain, and worries about pain held by adolescents with and without chronic pain. Adolescents with and without chronic pain aged 14-19 completed an online survey with free text questions about pain and worry. We collected demographics and used the Penn State Worry Questionnaire and Pain Catastrophizing Scale for Children to contextualize the qualitative data, which was analyzed with reflexive thematic analysis. Eighty-one participants completed the survey, 36 with chronic pain and 45 without (mean age: 16.73). Compared to adolescents without chronic pain, adolescents living with chronic pain reported significantly higher general worry and pain catastrophizing. Thematic analysis generated two themes, "Worry changes perceptions of selfhood" and "Pain changes perceptions of selfhood." Each theme comprised two sub-themes showing how current and future identity trajectories were distorted by worry and pain. The theme "Pain changes perceptions of selfhood" also included a third sub-theme: "Pain impedes future working choices." Worry content as well as process was problematic in all adolescents. Adolescents experiencing chronic pain had specific, additional worries that pain reduces future career progression. These worries appeared highly salient and challenging. Adolescents may need greater support in recognizing worry as part of normative development. Adolescents in pain may benefit from specific support identifying and reducing how pain-related worries interact with their futures and careers, and from school-based and vocational interventions to reduce the realistic risks they face negotiating modern labor markets.

Diverse Aspects of Worry among Younger and Older Adults: A Multifaceted Approach

The aims of this study were to examine age-differences regarding various worry components among younger and older adults and to characterize the relationships between worry domains and anxiety. A total of 311 younger adults (18 - 30 years) and 100 older adults (65+ years) completed seven worry and anxiety questionnaires, focusing on worry content, worry severity, and responses to worry. A series of 2 × 2 ANOVAs was computed to examine differences in worry and anxiety related to age and gender. Interaction effects indicated that gender differences among younger adults were significantly more pronounced than older adults with women reporting greater worry and anxiety than men. Main effects of age indicated that younger adults reported greater worry than older across all worry domains. Worry and anxiety measures were found to be highly correlated across all domains. Findings indicate that worry is fundamentally related to anxiety across age groups and that a variety of aspects of worry should be considered to understand the breadth of worry’s influence on anxiety. Additionally, age and gender have unique relationships with worry and anxiety and interact to complicate individuals’ symptom profiles. Thus, worry is a multifaceted construct that is crucial to understanding anxiety in general and warrants multifaceted assessment and intervention.

"Why Isn't It Going Away?": A Qualitative Exploration of Worry and Pain Experiences in Adolescents with Chronic Pain.

The role of cognition is central to the fear avoidance (FA) model of chronic pain (CP), which emphasizes the importance of catastrophic pain interpretations and has been shown to be applicable to pediatric CP populations. However, while we know that pain catastrophizing plays a distinct role in influencing outcomes for children with CP, we know little about the specifics of how young people with CP experience catastrophizing and worry, as well as their general pain beliefs. To qualitatively explore beliefs about and experiences of worry and pain among a purposeful sample of adolescents with CP. Individual semistructured interviews with 12 adolescents (aged 12-17) with varying forms of CP attending an outpatient pain clinic in a general children's hospital. Relevant psychometric measures were administered orally to further inform the data. Data were analyzed using critical realist thematic analysis. Three themes and one subtheme were identified. Themes were 1) the worry ripple: mind, body, and behavior (subtheme: worry content: personal competence and health); 2) the pain mystery: living in a "scribble of black"; and 3) the resist or avoid conundrum. The findings highlight the need for psychological interventions targeting acceptance of uncertainty and also informing education on mind/body connections in adolescents with CP.

An exploratory analysis of individual differences in mind wandering content and consistency.

We conducted an exploratory study of adult individual differences in the contents of mind-wandering experiences and in the moment-to-moment consistency of that off-task thought content within tasks. This secondary analysis of a published dataset (Kane et al., 2016) examined the content-based thought reports that 472–541 undergraduates made within five probed tasks across three sessions, and tested whether executive-control abilities (working memory capacity, attention-restraint ability), or personality dimensions of schizotypy (positive, disorganized, negative), predicted particular contents of task-unrelated thought (TUT) or the (in)stability of TUT content across successive thought reports. Latent-variable models indicated trait-like consistency in both TUT content and short-term TUT-content stability across tasks and sessions; some subjects mind-wandered about some things more than others, and some subjects were more temporally consistent in their TUT content than were others. Higher executive control was associated with more evaluative thoughts about task performance and fewer thoughts about current physical or emotional states; higher positive and disorganized schizotypy was associated with more fantastical-daydream and worry content. Contrary to expectations, executive ability correlated positively with TUT instability: higher-ability students had more shifting and varied TUT content within a task. Post hoc analysis suggested that better executive control predicted inconsistent TUT content because it also predicted shorter streaks of mind-wandering; tuning back in to task-related thought may decouple trains of off-task thought and afford novel spontaneous or cued thought content. [Data, sample analysis scripts and output, and article preprint are available via the Open Science Framework: https://osf.io/guhw7/].

Characterizing the nature of worry in a sample of perinatal women with generalized anxiety disorder.

Prevalence of perinatal anxiety disorders continues to grow, with estimates greater than those of postpartum depression. Generalized anxiety disorder (GAD) is the most commonly reported perinatal anxiety disorder, yet very little is known about the worry content experienced during the perinatal period in those with GAD. This study investigated worry content and frequency in a sample of perinatal women (n = 20) and age-matched nonperinatal women (n = 20) diagnosed with GAD. Participants completed the Penn State Worry Questionnaire (PSWQ) to assess worry severity, in addition to providing their current top worries. Mean scores on the PSWQ in both samples exceeded a clinical cut-off score of 65, and thematic analyses revealed that perinatal women experienced significantly greater parental-themed worries compared with the nonperinatal GAD sample (p < .05). Capturing the unique content of worry for perinatal woman will assist clinicians in identifying treatment targets and may enhance treatment outcome.

Expression of Generalized Anxiety Disorder Across the Lifespan.

In generalized anxiety disorder (GAD), both the associated symptoms and worry content have been shown to vary as a function of age (Jeste et al., 2005; Portman et al., 2011). However, few studies have conducted analyses beyond mean comparisons and no studies have examined whether the observed differences in worry content and the associated symptoms are due to the lack of measurement invariance across age groups. The current study evaluated whether the measurement and expression of GAD in adults varied as a function of age, using a clinical sample of 375 participants and dimensional measures of GAD. The sample was divided into three age groups (OLDER = 60+, MID = 40-59, YOUNG = 20-39), matched by sex and GAD status. Two associated symptoms were found to exhibit differential item functioning, overall distress/interference as well as fatigue, with higher levels distress/interference and lower levels of fatigue found in the OLDER age group despite equivalent GAD severity levels across groups. When examining the content of reported worries, differential item functioning was found in four worry domains. Holding the latent dimension of worry severity constant: (a) the YOUNG age group was found to have higher reported rate of social worries, and (b) the OLDER age group was found to have higher levels of reported worries about community/world affairs and health of self. The OLDER age group also exhibited lower levels of worry about work and school. These results are discussed with regard to the assessment of GAD across the lifespan.

Everyday worry in adolescents with and without chronic pain: a diary study

Young people report frequent worry, but we know little about the extent, character, or consequence of worry in adolescence, or individual differences associated with worry. Adolescents with chronic pain are one population that are known to have high levels of anxiety, which is associated with higher levels of disability and depression, impairing function. In this study we report a diary study: adolescents (N = 60; aged 16–18) recorded their worry over seven days. Our first aim was to describe the characteristics of adolescent worry and its consequences in a community sample. Our second aim was to compare the experience of girls to boys, and to compare the experience of those with and without chronic pain. Adolescents reported characteristics of each worry they had throughout the week, including content, frequency, strength, interference, emotion, and the strength of emotion associated with worry content. Adolescents reported the consequence for each content and the strength of the consequence. Worry content and consequences were categorised into four categories; health, relationship, personal competence, and other. Adolescents reported 675 unique episodes of worry over the seven-day period that were predominantly about personal competence. The strength of worry content was (M = 6.61, SD = 1.27) and the strength associated with the worry consequence was (M = 5.59, SD = 1.41). Worries were not reported as highly interfering (M = 4.14, SD = 1.61). Contrary to predictions, there were no differences in worry characteristics between adolescents with and without chronic pain. To conclude, worry is a frequent occurrence in older adolescents and the characteristics of worry are discussed. Adolescents worry mostly about personal competence. Adolescents with and without chronic pain reported similar worry characteristics.

Older adults report more sadness and less jealousy than young adults in response to worry induction

ABSTRACTObjectives: The present study examined age differences in descriptions of the experience of worry and worry content.Method: Twenty-eight older and 25 younger adults participated in an experimental manipulation of worry (i.e. 5-minute worry induction). Participants identified their three main worries and completed an emotion checklist before and after the induction.Results: After the induction, younger adults endorsed feeling fearful, impatient, and irritated, whereas older adults endorsed feeling tense or worrying. Older adults were more likely than younger adults to report feeling sad (χ2(53) = 7.52, p = .01), whereas younger adults were marginally more likely to report feeling jealous (χ2(53) = 4.34, p = .05). With regards to worry content, older adults worried more about community/world affairs (χ2 = 6.59, p = .01), whereas younger adults worried more about school (χ2 = 17.61, p < .001). Only age differences in worry about school remained significant after applying the Holm-Bonferroni correction.Conclusion: Following a worry induction, older and younger adults endorsed a wide variety of negative affect beyond the typical emotions associated with worry. Greater sadness experienced by older compared with younger adults highlights the importance of considering negative affect states, particularly depression, when working with older adult worriers.

Associations between adolescent sleep disturbance and different worry themes: findings from a repeated cross-sectional study from 1988 to 2011

ObjectiveThe objective was to investigate relationships between adolescent sleep disturbance and various worry themes. MethodsQuestionnaire data from 8 cross-sectional collections between 1988 and 2011 were used. The sample included more than 20,000 adolescents aged 15-16. Binary logistic regressions were used for the analyses. ResultsSleep disturbance and female sex increased the odds of worrying about all themes. Sleep disturbance shared stronger associations with worry about financial security, accidents/illness, being bullied, and terrorist attacks (odds ratios, 2.65-3.35) compared with worry about environmental destruction or nuclear war (odds ratios, 1.73-2.11). No interactions between sleep and year of investigation were found. ConclusionsLittle is known about the association between adolescent worry and sleep, and about sleep disturbance and specific worry content. This study shows that the strength in the relationship between adolescent worry and sleep varies with worry themes. Knowledge of the worry content related to sleep may aid in targeting preventions and interventions.

The development of worry throughout childhood: Avon Longitudinal Study of Parents and Children data

Anxiety is a normal part of childhood and adolescence; however, longitudinal research investigating the development of worrisome thoughts throughout childhood is lacking. This study investigated mothers' perspectives on their child's normal development of worry as the cognitive component of anxiety and its impact on child functioning in a longitudinal population-based cohort. The data for this study were extracted from the Avon Longitudinal Study of Parents and Children. Mothers (N = 2,227) reported on their child's worry content, frequency, control, emotional disruption, and interference when their child was 7, 10, and 13 years old using the parent component of the Development and Well-being Assessment. At age 10 and 13, pubertal status was assessed using children's self-report of pubic hair developmental progress. Mothers reported a peak of worrisome thoughts at 10. Emotional disruption was highest at 10, and the highest level of interference in daily life was observed at 13, especially for girls. Advanced pubertal status and worry frequency were positively associated for boys at 10 and girls at 13. Advanced puberty at 10 was also associated with overall higher worry frequency and emotional disruption. Findings are discussed within a developmental framework outlining the normal development of worrisome thoughts, associated distress, and interference throughout early adolescence. Increased knowledge of normative worry could be informative to further our understanding of adolescence as a vulnerable period for the development of mental health problems, such as generalized anxiety disorder. What is already known on this subject? Worrying is a normal part of childhood, making distinguishing between normal and pathological worrying challenging. Worry content remains consistent between age 4 and 7, but only for boys. The complexity and elaboration of worrisome thoughts increase from 8 years onwards. What does this study add? Worry frequency peaks at 10 and a low ability to control those worries can be observed at this age. The highest level of interference in performing daily activities due to worries is observed at age 13. Child sex and pubertal status play a role in understanding how normal worry patterns develop from age 10 onwards.