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

Press release

Friday, February 12, 2021

Findings about the impact of children’s temperament can 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 the Journal of the American Academy of Child and Adolescent Psychiatry, could help predict who is most at risk of developing anxiety during stressful life events in early adulthood and inform prevention and intervention efforts.

The researchers examined data from 291 participants who were followed from childhood to adulthood as part of a larger study on temperament and socioemotional development. The researchers found that participants who continued to exhibit a characteristic of temperament called behavioral inhibition in childhood were more likely to experience dysregulation of worry in adolescence (15 years), which in turn predicted elevated anxiety during the early months of the COVID- pandemic. 19, when the participants were in young adulthood (around 18 years old).

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

Behavioral inhibition is a childish temperament characterized by high levels of cautious, fearful and evasive responses to unknown people, objects and situations. Previous studies have established that children who exhibit behavioral inhibition are at 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 linked to anxiety in young adults.

The authors of this study raised the hypothesis that children who demonstrate a stable pattern of behavioral inhibition may be at a greater risk of deregulation of worry in adolescence, that is, difficulties in controlling worry and exhibiting inappropriate expressions of concern, and this would place them at greater risk in the future high anxiety during stressful events like 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 caution during an unstructured free play task with an unknown colleague. The deregulation of concern was assessed at age 15 through a self-report survey. For the current study, participants, with an average age of 18, were assessed for anxiety twice during the first months of the COVID-19 pandemic after issuing home stay orders (first between April 20 and April 15). May and approximately one month later).

In the first assessment, 20% of the participants reported moderate levels of anxiety symptoms considered in the clinical range. In the second assessment, 18.3% of participants reported clinical levels of anxiety. As expected, the researchers found that individuals with high behavioral inhibition in childhood who continued to exhibit high levels of social caution in childhood reported having unregulated concerns in adolescence, and this ended up predicting increased anxiety in adulthood during a critical stage of the pandemic. This developmental pathway was not significant for children who showed behavioral inhibition in early childhood, but showed low levels of social caution later in childhood.

“This study provides further evidence of the continuing impact of childhood temperament on individuals’ mental health,” said Nathan A. Fox, Ph.D., Distinguished University Professor and director of the Child Development Lab at the University of Maryland, College Park, and a of the study authors. “Young children with stable behavioral inhibition are at greater risk of greater concern and anxiety, and the context of the pandemic has only intensified these effects.”

The results suggest that directing social caution in childhood and deregulation of concern in adolescence may be a viable strategy for the prevention of anxiety disorders. The findings also suggest that addressing unregulated concern in adolescence may be particularly important in identifying those who may be at risk for high anxiety during stressful life events like the COVID-19 pandemic and preventing this high anxiety.

Grant: MH093349, HD017899

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

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

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