Gender Differences in Anxiety Trajectories from Middle to Late Adolescence

Abstract

Although developmental trajectories of anxiety symptomatology have begun to be explored, most research has focused on total anxiety symptom scores during childhood and early adolescence, using racially/ethnically homogenous samples. Understanding the heterogeneous courses of anxiety disorder symptoms during middle to late adolescence has the potential to clarify developmental risk models of anxiety and to inform prevention programs. Therefore, this study specifically examined gender differences in developmental trajectories of anxiety disorder symptoms (generalized anxiety disorder, panic disorder, and social anxiety disorder) from middle to late adolescence in a diverse community sample (N=1,000; 57% female; 65% White), assessed annually over two years. Latent growth curve modeling revealed that girls exhibited a slight linear decrease in generalized anxiety disorder, panic disorder, and social anxiety disorder symptoms, whereas boys exhibited a stable course. These models suggested that one trajectory was appropriate for panic disorder symptoms in both girls and boys. Growth mixture models indicated the presence of four latent generalized anxiety disorder symptom trajectory classes: low increasing, moderate decreasing slightly, high decreasing, and very high decreasing rapidly. Growth mixture models also suggested the presence of five latent social anxiety disorder symptom trajectory classes: a low stable trajectory class and four classes that were qualitatively similar to the latent generalized anxiety disorder trajectories. For both generalized anxiety disorder and social anxiety disorder symptoms, girls were significantly more likely than boys to be in trajectory classes characterized by moderate or high initial symptoms that subsequently decreased over time. These findings provide novel information regarding the developmental course of anxiety disorder symptoms in adolescents.

Prevalence and Treatment of Anxiety Disorders Comorbidities in a Clinical Romanian Sample of Children and Adolescents with Psychiatric Disorders

“…In a 5-year study of Dutch, youth aged between 10 and 12 years at baseline, generalized anxiety disorder, panic disorder, and social anxiety disorder symptoms slightly decreased and then leveled off from early to middle adolescence, followed by a slight increase in generalized anxiety disorder and social anxiety disorder symptoms during middle adolescence and in panic disorder symptoms during late adolescence [22,26]. Similar results have been reported by recent studies [24,27].…”

“…Recent studies showed that, in the general population, anxiety symptoms first decrease during early adolescence and subsequently increase from middle to late adolescence [22]. SAD and SPEC tend to emerge and predominate during childhood, whereas the initial onset of generalized anxiety disorder (GAD), panic disorder (PD), and social anxiety disorder (SAD) most often occurs during adolescence [24,46].…”

“…The literature describes the theory on distinct latent developmental trajectories for different anxiety disorder symptoms, emphasizing the importance of examining separate anxiety dimensions rather than considering anxiety as a general construct. For example, girls were significantly more likely than boys to be in numerous latent generalized anxiety disorder symptom trajectory classes, including those distinguished by very high initial symptoms that decrease rapidly, high initial symptoms that decrease less markedly over time, and moderate initial symptoms that decrease slightly over time [24]. The results from Crocetti et al's study regarding latent growth trajectory classes found that adolescent population was best typified by a low-anxiety class, characterized by a low initial anxiety level that decreased over time and a high-anxiety class characterized by a higher initial anxiety level that increased over time [25].…”

“…Similar to gender ratio for adults, girls tend to have more of all subtypes of anxiety disorders, but there is no significant difference between boys and girls in the mean age at onset of anxiety [28]. Some studies showed that girls have a higher risk to develop AD [13,16], are more affected [13,24], and report higher cross-sectional anxiety symptom levels [29][30][31], and these differences remain stable during adolescence [20].…”

Trajectories of childhood anxiety disorders in two generations at high risk

“…Moreover, we can identify predictors of anxiety disorder trajectories rather than predictors of anxiety onset or anxiety at a singular point in time. Identifying predictors of more persistent, chronic courses of anxiety disorders can help inform prognosis and target intervention efforts to those at a heightened risk for adverse outcomes (Asselmann & Beesdo‐Baum, 2015; Beesdo‐Baum & Knappe, 2012; Ginsburg et al, 2018; Ohannessian, Milan, & Vannucci, 2017).…”