Prevalence and course of anxiety disorders and symptoms from preschool to adolescence: a 6‐wave community study

Abstract

Background: The rate of various anxiety disorders in early childhood and whether they continue into middle childhood or adolescence is not known. We therefore report on the prevalence and stability of DSM-5-defined anxiety disorders and their symptoms, capturing the period from preschool to adolescence. Methods: By means of interviewer-based clinical interviews, anxiety was measured in a sample of Norwegian children at six measurement points from age 4 to 14 (n = 1,041). To adjust for time-invariant factors, we applied random intercept cross-lagged panel models (RI-CLPMs) capturing within-person changes. Results: Nearly 10% (95% CI = 7.29, 12.63) had an anxiety disorder at some timepoint. Specific phobia was the most prevalent disorder in early and middle childhood, whereas generalized anxiety disorder (GAD) increased in prevalence and became the most common anxiety disorder at age 14 (4.51%, 95% CI = 2.78, 6.23). When time-invariant confounding was adjusted for, homotypic continuity in anxiety symptoms typically first emerged in late middle childhood or adolescence. Even so, such within-person analyses revealed a heterotypic path from increased number of early childhood symptoms of specific phobia to increased number of GAD symptoms in middle childhood (B = .41, 95% CI = .06, .75). Increased separation anxiety in middle childhood predicted increased symptoms of GAD in adolescence (B = .38, 95% CI = .14, .62), and vice versa (B = .05, 95% CI = .00, .09). Only minor gender differences were revealed. Conclusions: Anxiety disorders are prevalent in childhood. In early childhood, anxiety symptoms generally do not predict later anxiety symptoms. In middle childhood, however, such symptoms are less likely to vanish, indicating this developmental period to be particularly important for preventive and treatment efforts.

Longitudinal relations between impaired executive function and symptoms of psychiatric disorders in childhood

“…There is no ready explanation as to why the effect appears during adolescence and not before. However, at least for emotional disorders, cognitively related symptoms (e.g., low self‐esteem feelings of guilt and hopelessness) and disorders (e.g., generalized anxiety) tend to increase during late middle childhood and adolescence (Morken et al., 2021 ; Steinsbekk et al., 2021 ), thus possibly taxing working memory to a larger extent than before. Increasing demands are likely placed on working memory in the late middle school and high school, and the above working memory problems may additionally become more evident to teachers (which we used as raters) at these ages than earlier.…”

“…Furthermore, although executive functions begin to emerge early in life, they continue to develop during the school years and adolescence (Diamond, 2013 ). The prevalence of different types of psychiatric disorders and symptoms also change from preschool to adolescence (Morken, Viddal, Ranum, & Wichstrom, 2021 ; Steinsbekk, Ranum, & Wichstrom, 2021 ). The relation between executive functions and the various mental health problems might thus also change during this period.…”

Population-Based Teacher-Rated Assessment of Anxiety Among Canadian Kindergarten Children

“…Parents of preschool children completed a questionnaire of select items from the CBCL [10] and the DISYPS-II [12], and the prevalence of anxiety disorders ranged from 3.4 to 10.7% [13]. In 2021, a study in Norway recruited a large sample of parents of 4-year-olds (n = 3456) during routine check-ups [14]. Parents completed the PAPA [11] and prevalence rates between 0.12 and 0.32% for specific anxiety disorders were reported.…”

Associations Between Delivery Modes, Birth Outcomes and Offspring Anxiety Disorders in a Population-Based Birth Cohort of Children and Adolescents

“…Anxiety disorders are the most common psychiatric disorders ( 1 ) and among the earliest to manifest during life ( 2 ). They may be prolonged, lead to secondary diagnoses and cause notable impairment ( 1 , 3 ). The etiological risk factors include some genetic and childhood environmental factors ( 4 ), but the role of perinatal factors is less clear, especially those during birth.…”