Advertisement

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 = 1000; 57 % female; 65 % White), assessed annually over 2 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.

This is a preview of subscription content, log in to check access.

Access options

Buy single article

Instant unlimited access to the full article PDF.

US$ 39.95

Price includes VAT for USA

Subscribe to journal

Immediate online access to all issues from 2019. Subscription will auto renew annually.

US$ 199

This is the net price. Taxes to be calculated in checkout.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Adkins, D. E., Wang, V., Dupre, M. E., Van den Oord, E. J., & Elder, G. H. (2009). Structure and stress: Trajectories of depressive symptoms across adolescence and young adulthood. Social Forces, 88(1), 31–60.

  2. Allan, N. P., Capron, D. W., Lejuez, C. W., Reynolds, E. K., MacPherson, L., & Schmidt, N. B. (2014). Developmental trajectories of anxiety symptoms in early adolescence: The influence of anxiety sensitivity. Journal of Abnormal Child Psychology, 42(4), 589–600.

  3. Arnett, J. J. (2015). Emerging adulthood: The winding road from the late teens through the twenties. 2nd edn. New York, NY: Oxford University Press.

  4. Beesdo, K., Knappe, S., & Pine, D. S. (2009). Anxiety and anxiety disorders in children and adolescents: developmental issues and implications for DSM-V. Psychiatric Clinics of North America, 32(3), 483–524.

  5. Beesdo-Baum, K., & Knappe, S. (2012). Developmental epidemiology of anxiety disorders. Child and Adolescent Psychiatric Clinics of North America, 21(3), 457–478.

  6. Birmaher, B., Khetarpal, S., Brent, D., Cully, M., Balach, L., Kaufman, J., & Neer, S. M. (1997). The screen for child anxiety related emotional disorders (SCARED): Scale construction and psychometric characteristics. Journal of the American Academy of Child and Adolescent Psychiatry, 36(4), 545–553. doi:10.1097/00004583-199704000-00018.

  7. Birmaher, B., Khetarpal, S., Cully, M., Brent, D., & McKenzie, S. (1995). Screen for child anxiety related disorders (SCARED) western psychiatric institute and clinic. Pittsburgh, PA: University of Pittsburgh.

  8. Boomsma, D., Van Beijsterveldt, C., & Hudziak, J. (2005). Genetic and environmental influences on anxious/depression during childhood: a study from the Netherlands Twin register. Genes, Brain and Behavior, 4(8), 466–481.

  9. Bozdogan, H. (1987). Model selection and Akaike’s information criterion (AIC): The general theory and its analytical extensions. Psychometrika, 52(3), 345–370.

  10. Broeren, S., Muris, P., Diamantopoulou, S., & Baker, J. R. (2013). The course of childhood anxiety symptoms: developmental trajectories and child-related factors in normal children. Journal of Abnormal Child Psychology, 41(1), 81–95.

  11. Buhi, E. R., Goodson, P., & Neilands, T. B. (2008). Out of sight, not out of mind: Strategies for handling missing data. American Journal of Health Behavior, 32(1), 83–92. doi:10.5993/AJHB.32.1.8.

  12. Burstein, M., Georgiades, K., Lamers, F., Swanson, S. A., Cui, L., He, J. -P., ... Merikangas, K. (2012). Empirically derived subtypes of lifetime anxiety disorders: Developmental and clinical correlates in US adolescents. Journal of Consulting and Clinical Psychology, 80(1), 102.

  13. Byrne, B.M. (2013). Structural equation modeling with AMOS: Basic concepts, applications, and programming. New York, NY: Routledge.

  14. Copeland, W. E., Shanahan, L., Costello, E. J., & Angold, A. (2009). Childhood and adolescent psychiatric disorders as predictors of young adult disorders. Archives of General Psychiatry, 66(7), 764–772.

  15. Crocetti, E., Klimstra, T., Keijsers, L., Hale, W. W., & Meeus, W. (2009). Anxiety trajectories and identity development in adolescence: A five-wave longitudinal study. Journal of Youth and Adolescence, 38(6), 839–849.

  16. Davey, C. G., Yücel, M., & Allen, N. B. (2008). The emergence of depression in adolescence: Development of the prefrontal cortex and the representation of reward. Neuroscience and Biobehavioral Reviews, 32(1), 1–19. doi:10.1016/j.neubiorev.2007.04.016.

  17. Duchesne, S., Vitaro, F., Larose, S., & Tremblay, R. E. (2008). Trajectories of anxiety during elementary-school years and the prediction of high school noncompletion. Journal of Youth and Adolescence, 37(9), 1134–1146.

  18. Eccles, J. S., & Roeser, R. W. (2011). Schools as developmental contexts during adolescence. Journal of Research on Adolescence, 21(1), 225–241.

  19. Ferdinand, R. F., Dieleman, G., Ormel, J., & Verhulst, F. C. (2007). Homotypic versus heterotypic continuity of anxiety symptoms in young adolescents: evidence for distinctions between DSM-IV subtypes. Journal of Abnormal Child Psychology, 35(3), 325–333.

  20. Forbes, E. E., & Dahl, R. E. (2010). Pubertal development and behavior: hormonal activation of social and motivational tendencies. Brain and Cognition, 72(1), 66–72.

  21. Hale, W. W., Raaijmakers, Q., Muris, P., & Meeus, W. (2005). Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in the general adolescent population. Journal of the American Academy of Child and Adolescent Psychiatry, 44(3), 283–290. doi:10.1097/00004583-200503000-00013.

  22. Hale, W. W., Raaijmakers, Q., Muris, P., & Meeus, W. (2008). Developmental trajectories of adolescent anxiety disorder symptoms: A 5-year prospective community study. Journal of the American Academy of Child and Adolescent Psychiatry, 47(5), 556–564. doi:10.1097/CHI.0b013e3181676583.

  23. Jung, T., & Wickrama, K. (2008). An introduction to latent class growth analysis and growth mixture modeling. Social and Personality Psychology Compass, 2(1), 302–317.

  24. Kendall, P. C., Compton, S. N., Walkup, J. T., Birmaher, B., Albano, A. M., Sherrill, J., ... Gosch, E. (2010). Clinical characteristics of anxiety disordered youth. Journal of Anxiety Disorders, 24(3), 360–365.

  25. Kendler, K., Gardner, C., & Lichtenstein, P. (2008). A developmental twin study of symptoms of anxiety and depression: evidence for genetic innovation and attenuation. Psychological Medicine, 38(11), 1567–1575.

  26. Kessler, R. C., Avenevoli, S., Costello, E. J., Georgiades, K., Green, J. G., Gruber, M. J., ... Petukhova, M. (2012). Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the national comorbidity survey replication adolescent supplement. Archives of General Psychiatry, 69(4), 372–380.

  27. Langley, A. K., Falk, A., Peris, T., Wiley, J. F., Kendall, P. C., Ginsburg, G., ... Piacentini, J. (2014). The child anxiety impact scale: Examining parent-and child-reported impairment in child anxiety disorders. Journal of Clinical Child and Adolescent Psychology, 43(4), 579–591. doi:10.1080/15374416.2013.817311.

  28. Leadbeater, B., Thompson, K., & Gruppuso, V. (2012). Co-occurring trajectories of symptoms of anxiety, depression, and oppositional defiance from adolescence to young adulthood. Journal of Clinical Child and Adolescent Psychology, 41(6), 719–730. doi:10.1080/15374416.2012.694608.

  29. Legerstree, J. S., Verhulst, F. C., Robbers, S. C. C., Ormel, J., Oldehinkel, A. J., & van Oort, F. V. A. (2013). Gender-specific developmental trajectories of anxiety during adolescence: Determinants and outcomes. The TRAILS study. Journal of the American Academy of Child and Adolescent Psychiatry, 22(1), 26–34.

  30. Letcher, P., Sanson, A., Smart, D., & Toumbourou, J. W. (2012). Precursors and correlates of anxiety trajectories from late childhood to late adolescence. Journal of Clinical Child and Adolescent Psychology, 41(4), 417–432. doi:10.1080/15374416.2012.680189.

  31. Lo, Y., Mendell, N. R., & Rubin, D. B. (2001). Testing the number of components in a normal mixture. Biometrika, 88(3), 767–778.

  32. Maldonado, L., Huang, Y., Chen, R., Kasen, S., Cohen, P., & Chen, H. (2013). Impact of early adolescent anxiety disorders on self-esteem development from adolescence to young adulthood. Journal of Adolescent Health, 53(2), 287–292.

  33. Marmorstein, N. R., White, H., Chung, T., Hipwell, A., Stouthamer-Loeber, M., & Loeber, R. (2010). Associations between first use of substances and change in internalizing symptoms among girls: Differences by symptom trajectory and substance use type. Journal of Clinical Child and Adolescent Psychology, 39(4), 545–558. doi:10.1080/15374416.2010.486325.

  34. McLaughlin, K. A., & King, K. (2015). Developmental trajectories of anxiety and depression in early adolescence. Journal of Abnormal Child Psychology, 43(2), 311–323.

  35. McLean, C. P., & Anderson, E. R. (2009). Brave men and timid women? A review of the gender differences in fear and anxiety. Clinical Psychology Review, 29(6), 496–505.

  36. Merikangas, K. R., He, J. -p, Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., ... Swendsen, J. (2010). Lifetime prevalence of mental disorders in US adolescents: Results from the national comorbidity survey replication–adolescent supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49(10), 980–989. doi:10.1016/j.jaac.2010.05.017.

  37. Morin, A. J., Maïano, C., Nagengast, B., Marsh, H. W., Morizot, J., & Janosz, M. (2011). General growth mixture analysis of adolescents’ developmental trajectories of anxiety: the impact of untested invariance assumptions on substantive interpretations. Structural Equation Modeling: A Multidisciplinary Journal, 18(4), 613–648.

  38. Muris, P., Merckelbach, H., Ollendick, T., King, N., & Bogie, N. (2002). Three traditional and three new childhood anxiety questionnaires: Their reliability and validity in a normal adolescent sample. Behaviour Research and Therapy, 40(7), 753–772.

  39. Muthen, L. K., & Muthen, B. O. (1998–2015). Mplus user’s guide: Statistical analysis with latent variables. 7th edn. Los Angeles, CA: Muthen & Muthen.

  40. Nagin, D. S. (1999). Analyzing developmental trajectories: A semiparametric, group-based approach. Psychological Methods, 4(2), 139.

  41. Negriff, S., & Susman, E. J. (2011). Pubertal timing, depression, and externalizing problems: A framework, review, and examination of gender differences. Journal of Research on Adolescence, 21(3), 717–746.

  42. Nelemans, S. A., Hale, W. W., Branje, S. J., Raaijmakers, Q. A., Frijns, T., van Lier, P. A., & Meeus, W. H. (2014). Heterogeneity in development of adolescent anxiety disorder symptoms in an 8-year longitudinal community study. Development and Psychopathology, 26(01), 181–202.

  43. Newman, M. G., Llera, S. J., Erickson, T. M., Przeworski, A., & Castonguay, L. G. (2013). Worry and generalized anxiety disorder: A review and theoretical synthesis of evidence on nature, etiology, mechanisms, and treatment. Annual Review of Clinical Psychology, 9, 275–297.

  44. Nylund, K. L., Asparouhov, T., & Muthén, B. O. (2007). Deciding on the number of classes in latent class analysis and growth mixture modeling: A Monte Carlo simulation study. Structural Equation Modeling: A Multidisciplinary Journal, 14(4), 535–569. doi:10.1080/10705510701575396.

  45. Ohannessian, C. M. (2009). Does technology use moderate the relationship between parental alcoholism and adolescent alcohol and cigarette use? Addictive Behaviors, 34(6), 606–609.

  46. Ohannessian, C. M., Lerner, R. M., Lerner, J. V., & von Eye, A. (1999). Does self-competence predict gender differences in adolescent depression and anxiety? Journal of Adolescence, 22(3), 397–411.

  47. Olatunji, B. O., & Cole, D. A. (2009). The longitudinal structure of general and specific anxiety dimensions in children: Testing a latent trait–state–occasion model. Psychological Assessment, 21(3), 412.

  48. Rood, L., Roelofs, J., Bögels, S. M., Nolen-Hoeksema, S., & Schouten, E. (2009). The influence of emotion-focused rumination and distraction on depressive symptoms in non-clinical youth: A meta-analytic review. Clinical Psychology Review, 29(7), 607–616.

  49. Rose, A. J. (2002). Co–rumination in the friendships of girls and boys. Child Development, 73(6), 1830–1843.

  50. Rose, A. J., & Rudolph, K. D. (2006). A review of sex differences in peer relationship processes: potential trade-offs for the emotional and behavioral development of girls and boys. Psychological Bulletin, 132(1), 98.

  51. Schwarz, G. (1978). Estimating the dimension of a model. The Annals of Statistics, 6(2), 461–464.

  52. Smetana, J. G., Campione-Barr, N., & Metzger, A. (2006). Adolescent development in interpersonal and societal contexts. Annual Review of Psychology, 57, 255–284. doi:10.1146/annurev.psych.57.102904.190124.

  53. Stapinski, L. A., Araya, R., Heron, J., Montgomery, A. A., & Stallard, P. (2015). Peer victimization during adolescence: Concurrent and prospective impact on symptoms of depression and anxiety. Anxiety, Stress, and Coping, 28(1), 105–120. doi:10.1080/10615806.2014.962023.

  54. Telzer, E. H., & Fuligni, A. J. (2013). Positive daily interactions eliminate gender differences in internalizing symptoms among adolescents. Journal of Youth and Adolescence, 42, 1498–1511.

  55. Tompkins, T. L., Hockett, A. R., Abraibesh, N., & Witt, J. L. (2011). A closer look at co-rumination: Gender, coping, peer functioning and internalizing/externalizing problems. Journal of Adolescence, 34(5), 801–811.

  56. U.S. Census Bureau (2008). U.S. Census Bureau: State and county QuickFacts. Retrieved May 16, 2010, from http://quickfacts.census.gov/qfd/states/10/10003.html.

  57. Van Oort, F., Greaves‐Lord, K., Ormel, J., Verhulst, F., & Huizink, A. (2011). Risk indicators of anxiety throughout adolescence: The TRAILS study. Depression and Anxiety, 28(6), 485–494.

  58. Van Oort, F., Greaves‐Lord, K., Verhulst, F., Ormel, J., & Huizink, A. (2009). The developmental course of anxiety symptoms during adolescence: The TRAILS study. Journal of Child Psychology and Psychiatry, 50(10), 1209–1217.

  59. Waters, S. K., Lester, L., & Cross, D. (2014). Transition to secondary school: Expectation versus experience. Australian Journal of Education, 58(2), 153–166.

  60. Weems, C. F. (2008). Developmental trajectories of childhood anxiety: Identifying continuity and change in anxious emotion. Developmental Review, 28(4), 488–502.

  61. Westenberg, P., Drewes, M. J., Goedhart, A. W., Siebelink, B. M., & Treffers, P. D. (2004). A developmental analysis of self‐reported fears in late childhood through mid‐adolescence: social‐evaluative fears on the rise? Journal of Child Psychology and Psychiatry, 45(3), 481–495.

  62. Wickrama, K., Lee, T. K., O’Neail, C. W., & Lorenz, F. O. (2016). ). Higher-Order Growth Curves and Mixture Modeling with Mplus. New York, NY: Routledge.

  63. Yurgelun-Todd, D. (2007). Emotional and cognitive changes during adolescence. Current Opinion in Neurobiology, 17(2), 251–257.

Download references

Acknowledgments

This research was supported by the National Institutes of Health grant K01-AA015059 (PI: Ohannessian). We would like to thank all of the adolescents who participated in this study. We also would like to acknowledge the Adolescent Adjustment Project staff, especially Kaitlin Flannery, Sarosh Khan, Jessica Schulz, Laura Finan, Kelly Cheeseman, Lisa Fong, Alyson Cavanaugh, Sara Bergamo, Ashley Malooly, and Ashley Ings, for their unmatched dedication to the implementation and conduct of this study. We are grateful to the schools and students who participated in the study.

Funding

This study was supported by NIH grant number K01-AA015059 awarded to Christine McCauley Ohannessian.

Author Contributions

CO conceived the study, designed the study, and took the lead in drafting the manuscript; SM performed statistical analysis, drafted portions of the manuscript, and participated in the interpretation of data; AV performed statistical analysis and participated in the interpretation of data and drafting the manuscript. All authors read and approved the final manuscript.

Author information

Correspondence to Christine McCauley Ohannessian.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interests.

Ethical Approval

(1) Statement of human rights: The study was approved by the appropriate institutional and/or national research ethics committee and has been conducted in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. (2) Statement on the welfare of animals: This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Ohannessian, C.M., Milan, S. & Vannucci, A. Gender Differences in Anxiety Trajectories from Middle to Late Adolescence. J Youth Adolescence 46, 826–839 (2017). https://doi.org/10.1007/s10964-016-0619-7

Download citation

Keywords

  • anxiety
  • adolescence
  • development
  • gender differences
  • trajectories