The Developmental Psychopathology of Worry

Abstract

Although childhood generalized anxiety disorder is generally understudied, worry, the cardinal feature of GAD, appears to be relatively common in youth. Despite its prevalence, there are few conceptual models of the development of clinical worry in children. The current review provides a framework for integrating the developmental psychopathology perspective, models of worry in adults, and data available on worry in children. General risk factors for the development of worry are considered, as well as potential pathways including genetics, temperament, cognitive, emotional and parenting influences, as well as the influence of cognitive development. Based on this review, it appears unlikely that main effects models will be able to explain the development of GAD or clinical worry in children and that a broad, complex model incorporating a number of factors and their interactions will best describe etiological and maintaining factors. With this perspective in mind, a number of suggestions for future work are offered.

A culturally-sensitive cognitive model of worry in African American youth.

“…Research on the development of worry suggests that this process results from a dynamic, complex interplay of multiple factors over time (Kertz & Woodruff-Borden, 2011). In particular, extant work has revealed several variables associated with worry and GAD in youth and adults, including biological (e.g., genes, temperament), environmental (e.g., parenting behaviors), cognitive (e.g., intolerance of uncertainty), and affective (e.g., emotion regulation) processes (see Kertz & Woodruff-Borden, 2011 for review).…”

“…In particular, extant work has revealed several variables associated with worry and GAD in youth and adults, including biological (e.g., genes, temperament), environmental (e.g., parenting behaviors), cognitive (e.g., intolerance of uncertainty), and affective (e.g., emotion regulation) processes (see Kertz & Woodruff-Borden, 2011 for review). While these risk factors demonstrate independent associations with worry, developmental models indicate that these variables interact and evince bidirectional relationships that yield multiple pathways to worry and GAD (see Kertz & Woodruff-Borden, 2011).…”

“…Although our understanding of the development of worry in children was once nebulous, a growing body of literature has begun to examine the etiological mechanisms and factors associated with worry in younger populations (see Kertz & Woodruff-Borden, 2011). While this empirical knowledge base remains underdeveloped compared to our understanding of causal and maintaining factors of worry in adults, burgeoning research provides preliminary support for the downward extension of adult models to youth.…”

“…While the existing evidence is promising, continued exploration of cognitive factors is particularly warranted, as integrated developmental models suggest that other etiological factors of worry may be mediated by these variables (Kertz & Woodruff-Borden, 2011).…”

A culturally-sensitive model of the development of child anxiety.

“…Thus, explanations of predisposing processes have become increasingly complex (e.g., Kertz & Woodruff-Borden, 2011;Rapee, 2001;Vasey & Dadds, 2001), while the influences that protect children against pathological anxiety are only broadly referenced. Although it is generally recognized that the absence of risk factors delineated in existing models may potentially mitigate negative outcomes, the specific factors and processes that promote resilient outcomes remain underspecified.…”