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The role of genetic and environmental factors in covariation between anxiety and anger in childhood


Higher levels of anger expression, as well as lower levels of anger control, have been reported for adults with anxiety disorders compared to individuals without anxiety disorders. Different to the research on adults, very few studies examined the relationship between anxiety and anger in childhood. In our study, we investigated 398 Italian twin pairs (74 MZ male, 70 MZ female, 134 same-sex dizygotic-53 male, 81 female-, and 120 unlike-sex dizygotic twin pairs), aged 8–17 (mean 13.06 ± 2.59): (i) the heritability of a childhood anger phenotype; (ii) the association between five anxiety domains and anger; (iii) the role of possible common etiological factors in explaining the observed comorbidity and overlap in the risk between anxiety phenotypes and anger. The study demonstrated that anger, assessed by CBCL items, is heritable in children at a similar rate to prior studies (40%). Our research found low to moderate rate of correlation between anger and anxiety (from 0.10 to 0.19). Finally, the present study found that the majority of etiological influences on anxiety and anger are independent of each other. Data showed that shared environmental influences have some small effects on the phenotypic covariation between the anxiety phenotypes and anger (12%); whereas unique environmental influences have an almost negligible effect (1%). Our analyses did not reveal the effect of genetic effects in explaining the covariation between these phenotypes.

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The authors are grateful to Dr. Anna Ogliari for help in data managing. We also thank all children and parents who took part in this study. The permission of Thomas Achenbach to employ the CBCL 6–18 for research purposes is also gratefully acknowledged.


Supported in part by the Italian Ministry of Health (Project no. OAB/F/2000 Grant BO16.1, Project: “Finalizzata 2007: Mental Health in Childhood and Adolescence” grant awarded to Marco Battaglia) and the Italian Ministry of University and Research (Project PRIN 06/006061953 awarded to Marco Battaglia). The first author of this paper was in the San Raffaele University Developmental Psychopathology PhD program, supported in part by the CARIPLO foundation ‘Human Talents’ grant for Academic Centres of Excellence in Post-Graduate Teaching (Marco Battaglia—recipient).

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All authors contributed to the study conception and design. Material preparation and data collection were performed by CF, MAS, MB. Analysis was performed by SS, GC, FL, SS and CB. The first draft of the manuscript was written by SS and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Simona Scaini.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The ethical committee of each participating institution accepted the procedures and the parents of all participants signed informed consent.

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Scaini, S., Centorame, G., Lissandrello, F. et al. The role of genetic and environmental factors in covariation between anxiety and anger in childhood. Eur Child Adolesc Psychiatry 30, 607–617 (2021).

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  • Anger
  • Anxiety
  • Twin study
  • Childhood