Hostname: page-component-8448b6f56d-sxzjt Total loading time: 0 Render date: 2024-04-23T09:45:29.566Z Has data issue: false hasContentIssue false
  • English
  • Français

The Relationship Between Worry and Dimensions of Anxiety Symptoms in Children and Adolescents

Published online by Cambridge University Press:  17 November 2016

Jonathan Rabner ,
Nicholas D. Mian ,
David A. Langer ,
Jonathan S. Comer  and
Donna Pincus
Jonathan Rabner*
Affiliation:
Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
Nicholas D. Mian
Affiliation:
Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA University of New Hampshire, Manchester, NH, USA
David A. Langer
Affiliation:
Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
Jonathan S. Comer
Affiliation:
Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA Department of Psychology, Florida International University, Miami, FL, USA
Donna Pincus
Affiliation:
Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
*
Correspondence to Jonathan Rabner, 648 Beacon Street, Boston, MA 02215, USA. E-mail: JRabner@bu.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Worry is a common feature across many anxiety disorders. It is important to understand how and when worry presents from childhood to adolescence to prevent long-term negative outcomes. However, most of the existing studies that examine the relationship between worry and anxiety disorders utilize adult samples. Aims: The present study aimed to assess the level of worry in children and adolescents and how relationships between worry and symptoms of separation anxiety disorder (SAD) and social anxiety disorder (Soc) may present differently at different ages. Method: 127 children (age 8–12 years) and adolescents (age 13–18 years), diagnosed with any anxiety disorder, presenting at a child anxiety out-patient clinic, completed measures of worry, anxiety and depression. Results: Worry scores did not differ by age group. Soc symptoms were significantly correlated with worry in both age groups; however, SAD symptoms were only significantly correlated with worry in younger participants. After the inclusion of covariates, SAD symptoms but not Soc symptoms remained significant in the regression model with younger children, and Soc symptoms remained significant in the regression model with older children. Conclusions: The finding that worry was comparable in both groups lends support for worry as a stable construct associated with anxiety disorders throughout late childhood and early adolescence.

Keywords

worryseparation anxietysocial anxietychildrenadolescents
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 45 , Issue 2 , March 2017 , pp. 124 - 138
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Angelino, H. & Shedd, C.L. (2015). Shifts in the content of fears and worries relative to chronological age. Proceedings of the Oklahoma Academy of Science, 34, 180–186.Google Scholar
Barlow, D.H., Allen, L.B. and Choate, M.L. (2004). Towards a unified treatment for emotional disorders. Behavior Therapy, 35, 205–230.CrossRefGoogle Scholar
Barlow, D.H., Conklin, L.R. and Bentley, K.H. (2015). Psychological treatments for panic disorders, phobias, and social and generalized anxiety disorders. In Nathan, P.E. and Gorman, J.M. (eds), A Guide to Treatments that Work, pp. 409–462. New York: Oxford University Press.Google Scholar
Beesdo, K., Knappe, S. and Pine, D.S. (2009). Anxiety and anxiety disorders in children and adolescents: Developmental issues and implications for DSM-V. The Psychiatric Clinics of North America, 32, 483–524.CrossRefGoogle ScholarPubMed
Burke, C.A. (2010). Mindfulness-based approaches with children and adolescents: A preliminary review of current research in an emergent field. Journal of Child and Family Studies, 19, 133–144.CrossRefGoogle Scholar
Chorpita, B.F. (2002). The tripartite model and dimensions of anxiety and depression: An examination of structure in a large school sample. Journal of Abnormal Child Psychology, 30, 177–190.CrossRefGoogle Scholar
Chorpita, B.F., Tracey, S.A., Brown, T.A., Collica, T.J. and Barlow, D.H. (1997). Assessment of worry in children and adolescents: An adaptation of the Penn State Worry Questionnaire. Behavioral Research and Therapy, 35, 569–581.CrossRefGoogle ScholarPubMed
Clark, L.A. and Watson, D. (1991). Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications. Journal of Abnormal Psychology, 100, 316–336.CrossRefGoogle ScholarPubMed
Clauss, J.A. and Blackford, J.U. (2012). Behavioral inhibition and risk for developing social anxiety disorder: a meta-analytic study. Journal of the American Academy of Child & Adolescent Psychiatry, 51, 1066–1075.CrossRefGoogle ScholarPubMed
Delgado, L.C., Guerra, P., Perakakis, P., Vera, M.N., del Paso, G.R. and Vila, J. (2010). Treating chronic worry: Psychological and physiological effects of a training programme based on mindfulness. Behaviour Research and Therapy, 48, 873–882.CrossRefGoogle ScholarPubMed
Dugas, M.J. and Robichaud, M. (2007). Cognitive-behavioral treatment for generalized anxiety disorder: From science to practice. New York/London: Routledge.Google Scholar
Ehrenreich, J.T., Goldstein, C.R., Wright, L.R. and Barlow, D.H. (2009). Development of a unified protocol for the treatment of emotional disorders in youth. Child & Family Behavior Therapy, 31, 20–37.CrossRefGoogle ScholarPubMed
Eley, T.C. & Stevenson, J. (1999). Using genetic analyses to clarify the distinction between depressive and anxious symptoms in children. Journal of Abnormal Child Psychology, 27, 105–114.CrossRefGoogle ScholarPubMed
Evans, S., Ferrando, S., Findler, M., Stowell, C., Smart, C. and Haglin, D. (2008). Mindfulness-based cognitive therapy for generalized anxiety disorder. Journal of Anxiety Disorders, 22, 716–721.CrossRefGoogle ScholarPubMed
Fialko, L., Bolton, D. and Perrin, S. (2012). Applicability of a cognitive model of worry to children and adolescents. Behaviour Research and Therapy, 50, 341–349.CrossRefGoogle ScholarPubMed
Flett, G.L., Coulter, L.M., Hewitt, P.L. and Nepon, T. (2011). Perfectionism, rumination, worry, and depressive symptoms in early adolescents. Canadian Journal of School Psychology, 26, 159–176.CrossRefGoogle Scholar
Franz, L., Angold, A., Copeland, W., Costello, E.J., Towe-Goodman, N. and Egger, H. (2013). Preschool anxiety disorders in pediatric primary care: Prevalence and comorbidity. Journal of the American Academy of Child and Adolescent Psychiatry, 52, 1294–1303.CrossRefGoogle ScholarPubMed
Garber, J. and Weersing, V.R. (2010). Comorbidity of anxiety and depression in youth: Implications for treatment and prevention. Clinical Psychology: A Publication of the Division of Clinical Psychology of the American Psychological Association, 17, 293–306.Google ScholarPubMed
Gladstone, G.L., Parker, G.B., Mitchell, P.B., Malhi, G.S., Wilhelm, K.A. and Austin, M.P. (2005). A brief measure of worry severity (BMWS): Personality and clinical correlates of severe worriers. Journal of Anxiety Disorders, 19, 877–892.CrossRefGoogle ScholarPubMed
James, A.C., James, G., Cowdrey, F.A., Soler, A. and Choke, A. (2015). Cognitive behavioural therapy for anxiety disorders in children and adolescents. Cochrane Database of Systematic Reviews, 2, 1–105.Google Scholar
Kessler, R.C., Avenevoli, S., Costello, H., Georgiades, K., Green, J.G., Gruber, M.J. and Merikangas, K.R. (2012). Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Archives of General Psychiatry, 69, 372–380.Google ScholarPubMed
Kessler, R.C., Berglund, P., Demler, O., Jin, R., Merikangas, K.R. and Walters, E.E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 593–602.CrossRefGoogle ScholarPubMed
Kertz, S.J., Bigda-Peyton, J.S., Rosmarin, D.H. and Björgvinsson, T. (2012). The importance of worry across diagnostic presentations: Prevalence, severity and associated symptoms in a partial hospital setting. Journal of Anxiety Disorders, 26, 126–133.CrossRefGoogle Scholar
Kovacs, M. (1992). Children's depression inventory. North Tonawanda, NY: Multi Health Systems.Google Scholar
March, J.S., Parker, J., Sullivan, K., Stallings, P. and Connor, C.K. (1997). The Multidimensional Scale for Children (MASC) factor structure, reliability, and validity. Journal of the American Academy of Child and Adolescent Psychiatry, 336, 554–565.CrossRefGoogle Scholar
McEvoy, P.M. and Brans, S. (2013). Common versus unique variance across measures of worry and rumination: Predictive utility and mediational models for anxiety and depression. Cognitive Therapy and Research, 37, 183–196.CrossRefGoogle Scholar
McEvoy, P.M., Watson, H., Watkins, E.R. and Nathan, P. (2013). The relationship between worry, rumination, and comorbidity: Evidence for repetitive negative thinking as a transdiagnostic construct. Journal of Affective Disorders, 151, 313–320.Google ScholarPubMed
Meyer, T.J., Miller, M.L., Metzger, R.L. and Borkovec, T.D. (1990). Development and validation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 28, 487–495.CrossRefGoogle ScholarPubMed
Mohlman, J., de Jesus, M., Gorenstein, E.E., Kleber, M., Gorman, J.M. and Papp, L.A. (2004). Distinguishing generalized anxiety disorder, panic disorder, and mixed anxiety states in older treatment-seeking adults. Anxiety Disorders, 18, 275–290.CrossRefGoogle ScholarPubMed
Muris, P., Merckelbach, H., Gadet, B. and Moulaert, V. (2000). Fears, worries, and scary dreams in 4-to 12-year-old children: Their content, developmental pattern, and origins. Journal of Clinical Child Psychology, 29, 43–52.CrossRefGoogle Scholar
Olatunji, B.O., Cisler, J.M. and Tolin, D.F. (2007). Quality of life in the anxiety disorders: A meta-analytic review. Clinical Psychology Review, 27, 572–581.CrossRefGoogle ScholarPubMed
Otto, M.W., Pollack, M.H., Maki, K.M., Gould, R.A., Worthington, J.J., Smoller, J.W. and Rosenbaum, J.F. (2001). Childhood history of anxiety disorders among adults with social phobia: rates, correlates, and comparisons with patients with panic disorder. Depression and Anxiety, 14, 209–213.CrossRefGoogle ScholarPubMed
Pestle, S.L., Chorpita, B.F. and Schiffman, J. (2008). Psychometric properties of the Penn State Worry Questionnaire for Children in a large clinical sample. Journal of Clinical Child and Adolescent Psychology, 37, 465–471.CrossRefGoogle Scholar
Robichaud, M., Dugas, M.J. and Conway, M. (2003). Gender differences in worry and associated cognitive-behavioral variables. Journal of Anxiety Disorders, 17, 501–516.CrossRefGoogle ScholarPubMed
Roemer, L. and Orsillo, S.M. (2002). Expanding our conceptualization of and treatment for generalized anxiety disorder: Integrating mindfulness/acceptance‐based approaches with existing cognitive‐behavioral models. Clinical Psychology: Science and Practice, 9, 54–68.Google Scholar
Rynn, M.A., Barber, J.P., Khalid-Khan, S., Siqueland, L., Dembiski, M., McCarthy, K.S. and Gallop, R. (2006). The psychometric properties of the MASC in a pediatric psychiatric sample. Anxiety Disorders, 20, 139–157.CrossRefGoogle Scholar
Shear, K., Jin, R., Ruscio, A.M., Walters, E.E. and Kessler, R.C. (2006) Prevalence and correlates of estimated DSM-IV child and adult separation anxiety disorder in the national comorbidity survey replication. American Journal of Psychiatry, 163, 1074–1083.CrossRefGoogle ScholarPubMed
Silverman, W.K. and Albano, A.M. (1996). The Anxiety Disorders Interview Schedule for Children for DSM-IV: (Child and Parent Versions). San Antonio, TX: Psychological Corporation.Google Scholar
Silverman, W.K., Greca, A.M. and Wasserstein, S. (1995). What do children worry about? Worries and their relation to anxiety. Child Development, 66, 671–686.CrossRefGoogle ScholarPubMed
Starcevic, V. (1995). Pathological worry in major depression: A preliminary report. Behaviour Research and Therapy, 33, 55–56.CrossRefGoogle ScholarPubMed
Starcevic, V., Berle, D., Milicevic, D., Hannan, A., Lamplugh, C. and Eslick, G.D. (2007). Pathological worry, anxiety disorders and the impact of co-occurrence with depressive and other anxiety disorders. Journal of Anxiety Disorders, 21, 1016–1027.CrossRefGoogle ScholarPubMed
van der Heiden, C., Muris, P. and van der Molen, H.T. (2012). Randomized controlled trial on the effectiveness of metacognitive therapy and intolerance-of-uncertainty therapy for generalized anxiety disorder. Behaviour Research and Therapy, 50, 100–109.Google ScholarPubMed
Vøllestad, J., Sivertsen, B. and Nielsen, G.H. (2011). Mindfulness-based stress reduction for patients with anxiety disorders: Evaluation in a randomized controlled trial. Behaviour Research and Therapy, 49, 281–288.Google ScholarPubMed
Weems, C.F. (2008). Developmental trajectories of childhood anxiety: Identifying continuity and change in anxious emotion. Developmental Review, 28, 488–502.CrossRefGoogle Scholar
Wells, A. (1995). Meta-cognition and worry: A cognitive model of generalized anxiety disorder. Behavioural and Cognitive Psychotherapy, 23, 301–320.CrossRefGoogle Scholar
Wells, A. (2005). The metacognitive model of GAD: Assessment of meta-worry and relationship with DSM-IV generalized anxiety disorder. Cognitive Therapy and Research, 29, 107–121.CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.