2009

This study investigated whether baseline cortisol measures predicted future anxiety, and compared cortisol values of groups with different developmental pathways of anxiety. Cortisol levels were assessed in 1768 individuals (10–12 years). Anxiety levels were assessed at the same age and 2 years later. Cortisol measures did not predict future anxiety levels. Individuals with persistent anxiety problems did not show higher morning cortisol levels than those with persistently low, decreasing, or increasing anxiety levels. Instead, individuals with persistently high anxiety levels showed significantly lower evening cortisol levels than all other individuals. Further, participants with increasing anxiety levels showed higher morning cortisol levels (area under the curve; AUC) than individuals with persistently low anxiety levels. The extent to which the HPA-axis – by itself – plays a role
in the aetiology of anxiety is questionable. Interactions of the HPA-axis with other biological or environmental factors may be more important.

This short report provides an overview of the results from a recent Dutch study on the relation between anxiety and the reactivity of two important stress response systems; the autonomic nervous system and the hypothalamic-pituitary-adrenal-axis. In future research, the reactivity of both stress response systems should be investigated in combination with several other important biological, psychological and social factors to gain more insight in the complex and interacting mechanisms underlying anxiety.

Background Little is known about the development of anxiety symptoms from late childhood to late adolescence. The present study determined developmental trajectories of symptoms of separation anxiety disorder (SAD), social phobia (SoPh), generalized anxiety disorder (GAD), panic disorder (PD), and obsessive-compulsive disorder (OCD) in a large prospective community cohort. Methods Anxiety symptoms were assessed in a community sample of 2220 boys and girls at three time-points across a 5-year interval. The Revised Child Anxiety and Depression Scale (RCADS) was used to assess anxiety symptoms, and multilevel growth-curve analyses were performed. Results All subtypes of anxiety first showed a decrease in symptoms (beta for age ranged from –0.05 to –0.13, p<0.0001), followed by a leveling off of the decrease, and a subsequent slight increase in symptoms (beta for age-squared ranged from 0.006 to 0.01, p<0.0001) from middle adolescence (GAD, SoPh, SAD) or late adolescence (PD and OCD) onwards. This increase in anxiety symptoms could not be explained by a co-occurring increase in depression symptoms. Girls had more anxiety symptoms than boys, and this difference remained stable during adolescence (p<0.0001). Gender differences were strongly attenuated by adjustment for symptoms of depression. Conclusions The current study shows that, in the general population, anxiety symptoms first decrease during early adolescence, and subsequently increase from middle to late adolescence. These findings extend our knowledge on the developmental course of anxiety symptoms during adolescence. This is the first study to separate the development of anxiety symptoms from that of symptoms of depression.