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

News release

Friday, February 12, 2021

Findings on the impact of temperament in children can help prevent anxiety.

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

The researchers examined data from 291 participants who had been tracked from toddler to young adulthood as part of a larger study of temperament and socio-emotional development. The researchers found that participants who continued to exhibit a temperament trait called behavioral inhibition in childhood were more likely to experience disruption of care during adolescence (age 15), which in turn predicted increased anxiety during the first months of the COVID-19 pandemic when the participants were in young adulthood (around the age of 18).

“People differ greatly in the way they deal with stress,” said Daniel Pine, MD, a study author and chief of the section on development and affective neuroscience at the National Institute of Mental Health (NIMH). “This study shows that children’s levels of anxiety predict how much stress they will experience later in life when faced with difficult circumstances, such as the pandemic.”

Behavioral inhibition is a childhood temperament characterized by high levels of cautious, fearful, and avoidant responses to unfamiliar people, objects, and situations. Previous studies have shown that children who exhibit behavior-inhibiting behavior have an increased risk of developing anxiety disorders later. However, less research has been done on the specific mechanisms by which a stable pattern of behavioral inhibition in childhood is associated with anxiety in young adulthood.

The authors of this study hypothesized that children who exhibit a stable pattern of behavioral inhibition are at greater risk of anxiety disorder during adolescence – that is, difficulty coping with worry and displaying inappropriate expressions of concern. and this would put them at greater risk for later. increased anxiety during stressful events such as the pandemic.

In the larger study, behavioral inhibition was measured at ages 2 and 3 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 wariness during an unstructured free play with an unknown peer. Disturbance of concern was assessed at age 15 by means of a self-report study. For the current study, at an average age of 18 years, participants were assessed twice for anxiety during the first months of the COVID-19 pandemic after home stays were enacted (first between April 20 and May 15 and about a month later).

At the initial assessment, 20% of the participants reported moderate levels of anxiety symptoms that were considered clinical. In the second review, 18.3% of the participants reported clinical levels of anxiety. As expected, the researchers found that individuals with high behavioral inhibition in toddlerhood who continued to exhibit a high degree of social wariness in childhood reported experiencing disturbed worry during adolescence, ultimately predicting increased anxiety in young adults during a critical period. phase of the pandemic. This developmental path was not significant for children who exhibited behavioral inhibitory behavior in toddlerhood, but showed a low degree of social caution later in childhood.

“This study provides further evidence of the continued impact of early life temperament on the mental health of individuals,” said Nathan A. Fox, Ph.D., Distinguished University Professor and Director of the Child Development Lab at the University of Maryland, College Park, and an author of the study. “Young children with stable behavioral inhibition are at greater risk of increased worry and fear, and the context of the pandemic has only amplified these effects.”

The findings suggest that addressing social cautiousness in childhood and anxiety disorder in adolescence may be a viable strategy for the prevention of anxiety disorders. The findings also suggest that addressing dysregulated concerns during adolescence may be especially important in identifying those who may be at risk for heightened anxiety during stressful life events such as the COVID-19 pandemic and in preventing that heightened anxiety.

Grant: MH093349, HD017899

About the National Institute of Mental Health (NIMH): The 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 cure. Visit the NIMH website for more information.

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

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