Study identifies risk factors for increased anxiety in young adults during the COVID-19 pandemic

Press release

Friday, February 12, 2021

Findings about the impact of childhood temperament could help with anxiety prevention efforts.

A new study identified early risk factors that predicted increased anxiety in young adults during the coronavirus pandemic (COVID-19). The results of the study, supported by the National Institutes of Health and published in Journal of the American Academy of Child and Adolescent Psychiatry, could help predict who is most at risk for developing anxiety during the stressful events of life in early adulthood and can inform prevention and intervention efforts.

The investigators examined data from 291 participants who had been followed from infancy to young adulthood as part of a larger study of temperament and socio-emotional development. The researchers found that participants who continued to show a temperament characteristic called behavioral inhibition in childhood were more likely to experience anxiety disorder in adolescence (age 15), which in turn predicted increased anxiety in the early stages. months of the COVID-19 pandemic when participants were young adults (around the age of 18).

“People differ a lot in how they deal with stress,” said Daniel Pine, MD, author of the study and head of the National Institute of Mental Health (NIMH) for Development and Affective Neuroscience. “This study shows that children’s level of fear predicts how much stress they face later in life when faced with difficult circumstances, such as a pandemic.”

Behavioral inhibition is a childhood temperament characterized by high levels of cautious, fearful, and avoidant responses to unknown people, objects, and situations. Previous studies have shown that children with behavioral inhibition have an increased risk of developing anxiety disorders later. However, less research has investigated the specific mechanisms by which a stable pattern of behavioral inhibition in childhood is related to anxiety in young adulthood.

The authors of this study hypothesized that children who demonstrate a stable pattern of behavioral inhibition may be at increased risk for dysregulation of adolescent anxiety — that is, difficulty managing anxiety and displaying inappropriate expressions of concern — and this would puts you at a higher risk for later. increased anxiety during stressful events such as pandemics.

In the larger study, behavioral inhibition was measured at 2 and 3 years of age, using observations of children’s responses to new toys and interaction with unknown adults. When the children were 7 years old, they were observed for social precaution during an unstructured free play task with an unknown colleague. The anxiety disorder was assessed at age 15 by a self-report survey. For the current study, participants, at a mean age of 18 years, were assessed for anxiety twice in the first months of the COVID-19 pandemic after home orders were issued (first between April 20 and May 15, and about a month later).

At the first evaluation, 20% of participants reported moderate levels of anxiety symptoms considered to be in the clinical range. At the second evaluation, 18.3% of participants reported clinical levels of anxiety. As expected, the researchers found that people with high behavioral inhibition in childhood, who continued to experience high levels of social caution in childhood, reported experiencing irregular anxiety in adolescence, and this predicted in the increased anxiety in young adulthood during a critical stage of the pandemic. This pathway of development was not significant for children who exhibited behavioral inhibition in childhood, but showed low levels of social caution later in childhood.

“This study provides additional evidence of the continuing impact of early life temperament on individuals’ mental health,” said Nathan A. Fox, Ph.D., a senior professor and director of the University of Maryland’s Child Development Laboratory. Park College and an author of the study. Young children with stable behavioral inhibition have an increased risk of anxiety and increased anxiety, and the context of the pandemic has only increased these effects.

The findings suggest that targeting social caution in childhood and deregulating anxiety in adolescence may be a viable strategy for preventing anxiety disorders. The findings also suggest that targeting irregular worries in adolescence may be particularly important for identifying those who may be at risk for increased anxiety during stressful life events, such as the COVID-19 pandemic, and for preventing increased anxiety.

Grant: MH093349, HD017899

About the National Institute of Mental Health (NIMH): NIMH’s mission is to transform the understanding and treatment of mental illness through basic and clinical research, paving the way for prevention, recovery and healing. For more information, visit the NIMH website.

About the National Institutes of Health (NIH):
NIH, the national medical research agency, includes 27 institutes and centers and is a component of the US Department of Health and Human Services. NIH is the leading federal agency that conducts and supports basic, clinical, and translational medical research and investigates the causes, treatments, and cures of both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

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