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Anxiety in Early Adolescence: Heterogeneous Developmental Trajectories, Associations with Risk Factors and Depressive Symptoms


This study aimed: (1) to identify heterogeneous trajectories of anxiety symptoms in early adolescence; (2) to analyze the relationships between risk factors and identified trajectories; (3) to study the association between anxiety symptom trajectories and depression symptom course. Anxiety and depressive symptoms of 825 participants (44.40% boys; mean initial age = 13.01, SD = 0.56) was assessed every 6 months over an 18-month period. Trajectory identification relied on latent-variable approach. As a result, 2–4 trajectories were identified for social phobia (SP), generalized anxiety (GA) and panic symptoms, revealing at least a low-symptom course and a trajectory of elevated symptoms (at-risk trajectory). Being girl and sibling cohabitation were related to at-risk trajectories, and a course of low effortful control and heightened negative affectivity. Finally, SP and GA symptoms were related to heightened depressive symptom courses. Relevant implications towards tailored prevention and intervention are highlighted to promote a healthy development across adolescence.

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  1. 1.

    Beesdo-Baum K, Knappe S (2012) Developmental epidemiology of anxiety disorders. Child Adolesc Psychiatr Clin N Am 21:457–478. https://doi.org/10.1016/j.chc.2012.05.001

  2. 2.

    Copeland WE, Angold A, Shanahan L, Costello EJ (2014) Longitudinal patterns of anxiety from childhood to adulthood: the Great Smoky Mountains Study. J Am Acad Child Adolesc Psychiatry 53:21–33. https://doi.org/10.1016/j.jaac.2013.09.017

  3. 3.

    Essau CA, Lewinsohn PM, Olaya B, Seeley JR (2013) Anxiety disorders in adolescents and psychosocial outcomes at age 30. J Affect Dis 163:125–132. https://doi.org/10.1016/j.jad.2013.12.033

  4. 4.

    Lee KS, Vaillancourt T (2019) A four-year prospective study of bullying, anxiety, and disordered eating behavior across early adolescence. Child Psychiatry Hum Dev. https://doi.org/10.1007/s10578-019-00884-7

  5. 5.

    Pine DS, Fox NA (2015) Childhood antecedents and risk for adult mental disorders. Ann Rev Psychol 66:459–485. https://doi.org/10.1146/annurev-psych-010814-015038

  6. 6.

    Cohen JR, Andrews AR, Davis MM, Rudolph KD (2018) Anxiety and depression during childhood and adolescence: testing theoretical models of continuity and discontinuity. J Abnorm Child Psychol 46:1295–1308. https://doi.org/10.1007/s10802-017-0370-x

  7. 7.

    Leadbeater B, Thompson K, Gruppuso V (2012) Co-occurring trajectories of symptoms of anxiety, depression, and oppositional defiance from adolescence to young adulthood. J Clin Child Adolesc Psychol 41:719–730. https://doi.org/10.1080/15374416.2012.694608

  8. 8.

    McLaughlin KA, King K (2015) Developmental trajectories of anxiety and depression in early adolescence. J Abnorm Child Psychol 43:311–323. https://doi.org/10.1007/s10802-014-9898-1

  9. 9.

    Van Oort FVA, Greaves-Lord K, Ormel J et al (2011) Risk indicators of anxiety throughout adolescence: the TRAILS study. Depress Anxiety 28:485–494. https://doi.org/10.1002/da.20818

  10. 10.

    Weems CF (2008) Developmental trajectories of childhood anxiety: identifying continuity and change in anxious emotion. Dev Rev 28:488–502. https://doi.org/10.1016/j.dr.2008.01.001

  11. 11.

    Forbes MK, Rapee RM, Camberis AL, McMahon CA (2017) Unique associations between childhood temperament characteristics and subsequent psychopathology symptom trajectories from childhood to early adolescence. J Abnorm Child Psychol 45:1221–1233. https://doi.org/10.1007/s10802-016-0236-7

  12. 12.

    Nelemans SA, Hale WW, Branje SJT et al (2014) Heterogeneity in development of adolescent anxiety disorder symptoms in an 8-year longitudinal community study. Dev Psychopathol 26:181–202. https://doi.org/10.1017/S0954579413000503

  13. 13.

    Allan NP, Capron DW, Lejuez CW et al (2014) Developmental trajectories of anxiety symptoms in early adolescence: the influence of anxiety sensitivity. J Abnorm Child Psychol 42:589–600. https://doi.org/10.1007/s10802-013-9806-0

  14. 14.

    Nivard MG, Lubke GH, Dolan CV et al (2017) Joint developmental trajectories of internalizing and externalizing disorders between childhood and adolescence. Dev Psychopathol 29:919–928. https://doi.org/10.1017/S0954579416000572

  15. 15.

    Miers AC, Blote AW, de Rooij M et al (2013) Trajectories of social anxiety during adolescence and relations with cognition, social competence, and temperament. J Abnorm Child Psychol 41:97–110. https://doi.org/10.1007/s10802-012-9651-6

  16. 16.

    Zimmer-Gembeck MJ, Webb HJ, Farrell LJ, Waters AM (2018) Girls’ and boys’ trajectories of appearance anxiety from age 10 to 15 years are associated with earlier maturation and appearance-related teasing. Dev Psychopathol 30:337–350. https://doi.org/10.1017/S0954579417000657

  17. 17.

    Ohannessian CM, Milan S, Vannucci A (2017) Gender differences in anxiety trajectories from middle to late adolescence. J Youth Adolesc 46:826–839. https://doi.org/10.1007/s10964-016-0619-7

  18. 18.

    Grills-Taquechel AE, Norton P, Ollendick TH (2010) A longitudinal examination of factors predicting anxiety during the transition to middle school. Anxiety Stress Coping 23:493–513. https://doi.org/10.1080/10615800903494127

  19. 19.

    Andersen SL (2003) Trajectories of brain development: point of vulnerability or window of opportunity? Neurosci Biobehav Rev 27:3–18. https://doi.org/10.1016/S0149-7634(03)00005-8

  20. 20.

    Blakemore SJ, Mills KL (2014) Is adolescence a sensitive period for sociocultural processing? Ann Rev Psychol 65:9.1–9.21. https://doi.org/10.1146/annurev-psych-010213-115202

  21. 21.

    Fuhrmann D, Knoll LJ, Blakemore SJ (2015) Adolescence as a sensitive period of brain development. Trends Cogn Sci 19:558–566. https://doi.org/10.1016/j.tics.2015.07.008

  22. 22.

    Christiansen DM (2015) Examining sex and gender differences in anxiety disorders. In: Durbano F (ed) A fresh look at anxiety disorders. Tech Open Access Publishers, New York, pp 17–49. https://doi.org/10.5772/60662

  23. 23.

    Dirks MA, Persram R, Recchia HE, Howe N (2015) Sibling relationships as sources of risk and resilience in the development and maintenance of internalizing and externalizing problems during childhood and adolescence. Clin Psychol Rev 42:145–155. https://doi.org/10.1016/j.cpr.2015.07.003

  24. 24.

    Poirier CS, Brendgen M, Vitaro F, Dionne G, Boivin M (2017) Contagion of anxiety symptoms among adolescent siblings: a Twin Study. J Res Adolesc 27:65–77. https://doi.org/10.1111/jora.12254

  25. 25.

    De Pauw SSW, Mervielde I (2010) Temperament, personality and developmental psychopathology: a review based on the conceptual dimensions underlying childhood traits. Child Psychiatry Hum Dev 41:313–329. https://doi.org/10.1007/s10578-009-0171-8

  26. 26.

    Tortella-Feliu M, Balle M, Sese A (2010) Relationships between negative affectivity, emotion regulation, anxiety, and depressive symptoms in adolescents as examined through structural equation modeling. J Anxiety Disord 24:686–693. https://doi.org/10.1016/j.janxdis.2010.04.012

  27. 27.

    Rothbart MK (2007) Temperament, development, and personality. Curr Dir Psychol Sci 16:207–212

  28. 28.

    Rothbart MK, Bates JE (2006) Temperament. In: Eisenberg N, Damon W (eds) Handbook of child psychology: vol. 3. Social, emotional, and personality development, 6th edn. Wiley, New York, pp 99–166

  29. 29.

    Muris P (2006) Unique and interactive effects of neuroticism and effortful control on psychopathological symptoms in non-clinical adolescents. Pers Individ Differ 40:1409–1419. https://doi.org/10.1016/j.paid.2005.12.001

  30. 30.

    Snyder HR, Gulley LD, Bijttebier P et al (2015) Adolescent emotionality and effortful control: core latent constructs and links to psychopathology and functioning. J Pers Soc Psychol 109:1132–1149. https://doi.org/10.1037/pspp0000047

  31. 31.

    Capaldi DM, Rothbart MK (1992) Development and validation of an early adolescent temperament measure. J Early Adolesc 12:153–173

  32. 32.

    Nigg JT (2006) Temperament and developmental psychopathology. J Child Psychol Psychiatry 47:395–422. https://doi.org/10.1111/j.1469-7610.2006.01612.x

  33. 33.

    De la Torre-Luque A, Fiol-Veny A, Bornas X et al (2017) Impaired cardiac profile in adolescents with an increasing trajectory of anxiety when confronting an acute stressor. Eur Child Adolesc Psychiatry 26:1501–1510. https://doi.org/10.1007/s00787-017-1009-8

  34. 34.

    Hoffmann MS, Pan PM, Manfro GG et al (2018) Cross-sectional and longitudinal associations of temperament and mental disorders in youth. Child Psychiatry Hum Dev. https://doi.org/10.1007/s10578-018-0846-0

  35. 35.

    Laceulle OM, Ormel J, Vollerbergh WAM et al (2014) A test of the vulnerability model: temperament and temperament change as predictors of future mental disorders—the TRAILS study. J Child Psychol Psychiatry 55:227–236. https://doi.org/10.1111/jcpp.12141

  36. 36.

    Wang B, Brueni LG, Isensee C et al (2018) Predictive value of dysregulation profile trajectories in childhood for symptoms of ADHD, anxiety and depression in late adolescence. Eur Child Adolesc Psychiatry 27:764–774. https://doi.org/10.1007/s00787-017-1059-y

  37. 37.

    Musliner KL, Munk-Olsen T, Eaton WW, Zandi PP (2016) Heterogeneity in long-term trajectories of depressive symptoms: patterns, predictors and outcome. J Affect Disord 192:199–211. https://doi.org/10.1016/j.jad.2015.12.030

  38. 38.

    Bornas X, Llabres J, Balle M et al (2014) The use of a secure social network for the study of anxiety in adolescence. Rev Psicopatol Psicol Clin 19:171–184. https://doi.org/10.5944/rppc.vol.19.num.3.2014.13899

  39. 39.

    Chorpita BF, Yim L, Moffitt C et al (2000) Assessment of symptoms of DSM-IV anxiety and depression in children: a revised child anxiety and depression scale. Behav Res Ther 38:835–855

  40. 40.

    Sandin B, Valiente RM, Chorot P (2009) RCADS: assessment of anxiety and depressive disorder symptoms in children and adolescents. Span J Clin Psychol 14:193–206

  41. 41.

    Ellis LK, Rothbart MK (2001) Revision of the early adolescent temperament questionnaire. Poster presented at the Biennial Meeting of the Society for Research in Child Development, Minneapolis, MN

  42. 42.

    Rothbart MK (2019) Mary Rothbart’s temperament questionnaires. https://research.bowdoin.edu/rothbart-temperament-questionnaires/instrument-descriptions/the-early-adolescent-temperament-questionnaire/

  43. 43.

    Muris P, Meesters C (2009) Reactive and regulative temperament in youths: psychometric evaluation of the Early Adolescent Temperament Questionnaire-Revised. J Psychopathol Behav Assess 31:7–19. https://doi.org/10.1007/s10862-008-9089-x

  44. 44.

    Proust-Lima C, Philipps V, Liquet B (2017) Estimation of extended mixed models using latent classes and latent processes: the R package lcmm. J Stat Softw. https://doi.org/10.18637/jss.v078.i02

  45. 45.

    Proust-Lima C, Jacqmin-Gadda H (2005) Estimation of linear mixed models with a mixture of distribution for the random-effects. Comput Methods Progr Biomed 78:165–173. https://doi.org/10.1016/j.cmpb.2004.12.004

  46. 46.

    Jung T, Wickrama KAS (2008) An introduction to latent class growth analysis and growth mixture modeling. Soc Pers Psychol Compass 2(1):302–317. https://doi.org/10.1111/j.1751-9004.2007.00054.x

  47. 47.

    Carriere I, Farre A, Proust-Lima C et al (2016) Chronic and remitting trajectories of depressive symptoms in the elderly. Characterisation and risk factors. Epidemiol Psychiatr Sci 1:1

  48. 48.

    Akogul S, Erisoglu M (2017) An approach for determining the number of clusters in a model-based cluster analysis. Entropy 19:452. https://doi.org/10.3390/e19090452

  49. 49.

    Proust-Lima C, Sene M, Taylor JM, Jacqmin-Gadda H (2014) Joint latent class models for longitudinal and time-to-event data: a review. Stat Methods Med Res 23:74–90. https://doi.org/10.1177/0962280212445839

  50. 50.

    McArdle JJ (2009) Latent variable modeling of differences and changes with longitudinal data. Ann Rev Psychol 60:577–605. https://doi.org/10.1146/annurev.psych.60.110707.163612

  51. 51.

    Widaman KF, Ferrer E, Conger RD (2010) Factorial invariance within longitudinal structural equation models: measuring the same construct across time. Child Dev Perspect 4:10–18. https://doi.org/10.1111/j.1750-8606.2009.00110.x

  52. 52.

    Satorra A, Bentler PM (1994) Corrections to test statistics and standard enors in covariance structure analysis. In: Von Eye A, Clogg CC (eds) Latent variables analysis: applications for developmental research. Sage, Thousand Oaks, pp 399–419

  53. 53.

    Cheung GW, Rensvold RB (2002) Evaluating goodness-of-fit indexes for testing measurement invariance. Struct Equ Modeling 9:233–255. https://doi.org/10.1207/S15328007SEM0902_5

  54. 54.

    Rutkowski L, Svetina D (2014) Assessing the hypothesis of measurement invariance in the context of large-scale international surveys. Educ Psychol Meas 74:31–57. https://doi.org/10.1177/0013164413498257

  55. 55.

    Chorpita BF, Moffitt C, Gray J (2005) Psychometric properties of the Revised Child Anxiety and Depression Scale in a clinical sample. Behav Res Ther 43:309–322

  56. 56.

    Nelemans SA, Hale WW, Branje S, Meeus WHJ (2017) Individual differences in anxiety trajectories from Grades 2 to 8: impact of the middle school transition. Dev Psychopathol. https://doi.org/10.1017/S0954579417001584

  57. 57.

    Zerwas S, Von Holle A, Watson H et al (2014) Childhood anxiety trajectories and adolescent disordered eating: findings from the NICHD study of early child care and youth development. Int J Eat Disord 47:784–792. https://doi.org/10.1002/eat.22318

  58. 58.

    McLean CP, Anderson ER (2009) Brave men and timid women? A review of the gender differences in fear and anxiety. Clin Psychol Rev 29:496–505. https://doi.org/10.1016/j.cpr.2009.05.003

  59. 59.

    Liao M, Yang F, Zhang Y et al (2014) Lack of gender effects on gray matter volumes in adolescent generalized anxiety disorder. J Affect Disord 155:278–282. https://doi.org/10.1016/j.jad.2013.10.049

  60. 60.

    Laursen B, Collins WA (2009) Parent-child relationships during adolescence. In: Lerner RM, Steinberg L (eds) Handbook of adolescent psychology. Wiley, Hoboken. https://doi.org/10.1002/9780470479193.adlpsy002002

  61. 61.

    Bornas X, Balle M, de la Torre-Luque A et al (2015) Ecological assessment of heart rate complexity: differences between high- and low-anxious adolescents. Int J Psychophysiol 98:112–118. https://doi.org/10.1016/j.ijpsycho.2015.07.007

  62. 62.

    Vijayakumar N, Whittle S, Dennison M et al (2014) Development of temperamental effortful control mediates the relationship between maturation of the prefrontal cortex and psychopathology during adolescence: a 4-year longitudinal study. Dev Cogn Neurosci 9:30–43. https://doi.org/10.1016/j.dcn.2013.12.002

  63. 63.

    Nigg JT (2017) On the relations among self-regulation, self-control, executive functioning, effortful control, cognitive control, impulsivity, risk-taking, and inhibition for developmental psychopathology. J Child Psychol Psychiatry. https://doi.org/10.1111/jcpp.12675

  64. 64.

    Rothbart MK, Sheese BE, Rueda MR, Posner MI (2011) Developing mechanisms of self-regulation in early life. Emot Rev 3:207–213. https://doi.org/10.1177/1754073910387943

  65. 65.

    Blair KS, Geraci M, Smith BW et al (2012) Reduced dorsal anterior cingulate cortical activity during emotional regulation and top-down attentional control in generalized social phobia, generalized anxiety disorder, and comorbid generalized social phobia/generalized anxiety disorder. Biol Psychiatry 72:476–482. https://doi.org/10.1016/j.biopsych.2012.04.013

  66. 66.

    Mennin DS, McLaughlin KA, Flanagan TJ (2009) Emotion regulation deficits in generalized anxiety disorder, social anxiety disorder, and their co-occurrence. J Anxiety Disord 23:866–871. https://doi.org/10.1016/j.janxdis.2009.04.006

  67. 67.

    Cuthbert BN, Lang PJ, Strauss C et al (2003) The psychophysiology of anxiety disorder: fear memory imagery. Psychophysiol 40:407–422. https://doi.org/10.1111/1469-8986.00043

  68. 68.

    Smoller JW, Gardner-Schuster E, Covino J (2008) The genetic basis of panic and phobic anxiety disorders. Am J Med Genet C Semin Med Genet 148C:118–126. https://doi.org/10.1002/ajmg.c.30174

  69. 69.

    Wen A, LeMoult J, McCabe R, Youn KL (2019) Affective flexibility and generalized anxiety disorder: valence-specific shifting difficulties. Anxiety Stress Coping 32:581–593. https://doi.org/10.1080/10615806.2019.1638684

  70. 70.

    Longley SL, Watson D, Noyes R, Yoder K (2006) Panic and phobic anxiety: associations among neuroticism, physiological hyperarousal, anxiety sensitivity, and three phobias. Anxiety Disord 20:718–739

  71. 71.

    Cummings CM, Caporino NE, Kendall PC (2014) Comorbidity of anxiety and depression in children and adolescents: 20 years after. Psychol Bull 140:816–845. https://doi.org/10.1037/a0034733

  72. 72.

    De la Torre-Luque A, Essau CA (2019) Symptom network connectivity in adolescents with comorbid major depressive disorder and social phobia. J Affect Dis 255:60–68. https://doi.org/10.1016/j.jad.2019.05.015

  73. 73.

    Melton TH, Croarkin PE, Strawn JR, McClintock SM (2016) Comorbid anxiety and depressive symptoms in children and adolescents: a systematic review and analysis. J Psychiatr Pract 22:84–98. https://doi.org/10.1097/PRA.0000000000000132

  74. 74.

    Diallo TMO, Lu H (2017) On the application of the three-step approach to growth mixture models. Struct Equ Model 24:714–732. https://doi.org/10.1080/10705511.2017.1322516

  75. 75.

    Vermunt JK (2010) Latent class modeling with covariates: two improved three-step approaches. Polit Anal 18:450–469. https://doi.org/10.1093/pan/mpq025

  76. 76.

    Hope TL, Adams C, Reynolds L et al (1999) Parent vs. self-report: contributions toward diagnosis of adolescent psychopathology. J Psychopathol Behav Assess 21:349–363

  77. 77.

    Kim H, Di Domenico SI, Connelly BS (2018) Self–other agreement in personality reports: a meta-analytic comparison of self- and informant-report means. Psychol Sci. https://doi.org/10.1177/0956797618810000

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This study was supported by the Spanish Ministry of Economy and Competitiveness Grants Ref. PSI2012-34780 and PSI2016-78403-P.

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Correspondence to Alejandro de la Torre-Luque.

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de la Torre-Luque, A., Fiol-Veny, A., Balle, M. et al. Anxiety in Early Adolescence: Heterogeneous Developmental Trajectories, Associations with Risk Factors and Depressive Symptoms. Child Psychiatry Hum Dev (2019). https://doi.org/10.1007/s10578-019-00936-y

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  • Anxiety symptoms
  • Development
  • Temperament
  • Adolescence
  • Growth mixture modeling