Risk factors for anxiety in adolescence

There is a common vulnerability to all anxiety disorders , which is related to the presence of the following factors: introverted and shy traits; a temperamental trait of behavioral inhibition; a family history of anxiety or other psychopathological difficulties; and negative life experiences. A risk factor is anything that increases the likelihood of developing a psychopathological disorder.

In general, anxiety disorders are considered to be explained by the interaction of different factors, such as:

Genetic factors

Family history and familial variables: having one parent with an anxiety disorder increases the risk of experiencing anxiety. Furthermore, numerous studies have focused on the relationship between parenting styles and their association with anxiety symptoms in children. In this regard, parenting styles characterized by excessive control and overprotection appear to be significant risk factors, as they limit children's autonomy and independence. Adolescents with more genetic risk factors may experience anxiety even in the absence of a real threat, describing feelings of constant nervousness, restlessness, or heightened stress, with difficulty feeling relaxed and calm.

Characteristics of family communication in adolescence

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Temperament in childhood

Temperament is the inherited individuality that affects how each person thinks, feels, and acts. It is the individual's constitutional tendency to react in a certain way to the environment. Basically, two temperamental traits have been associated with anxiety disorders: behavioral inhibition (BI) and anxiety sensitivity (AS). BI is one of the most relevant risk factors for developing anxiety disorders. It is defined as the tendency to exhibit fear, avoidance, or caution in novel situations and/or with unfamiliar people.

Children with IC are characterized by the fact that, in these situations, they tend to show:

• Difficulty tolerating changes or new things.
• Slowness to gain confidence with strangers.
• Little smile.
• Seek close proximity to attachment figures.
• Speak little.
• Shy gaze, avoidance of eye contact.
• Not wanting to explore new situations.

On the other hand, anxiety sensitivity is defined as the tendency to experience fear when faced with anxiety symptoms, exhibiting cognitive biases and a tendency to interpret them catastrophically. In this sense, any somatic change is detected very early and interpreted as a threat, for example, thinking that one might have a heart attack upon perceiving a slight increase in heart rate. Studies show that the presence of significant anxiety sensitivity predicts the onset of anxiety-related problems within two years. It has also been observed that anxiety sensitivity predicts the development of social phobia in adolescence, and anxiety sensitivity is more closely associated with panic disorder, somatic symptoms, and anxiety disorders.

Sociodemographic factors

Age and sex are sociodemographic factors. In this regard, numerous studies report a higher risk of developing any anxiety disorder in girls. This is particularly evident in PTSD, where a greater difference between the sexes is observed. Regarding age, puberty is known to be the developmental period of greatest vulnerability and risk for the onset of anxiety problems, around age eleven. The onset of anxiety disorders occurs much earlier than other major adolescent problems such as mood disorders, behavioral problems, and substance use disorders.

Environmental triggering factors

Life events such as parental separation, changing schools, etc., or other more stressful events (for example, experiencing abuse) are associated with the development of anxiety disorders in biologically vulnerable individuals. Specifically, the presence of victimization and bullying among peers during adolescence is associated with medium- and long-term symptoms of anxiety and depression due to persistent psychological stress.

Psychological factors

Adolescents with anxiety often have more thoughts that inform them of threats in their environment. For example, an adolescent with social anxiety will have more thoughts related to social threats ("others won't like me"), children with separation anxiety will have more thoughts related to threats to their parents' well-being ("something will happen to them and I'll be left alone"), and so on. This attentional bias toward potential threats and the bias toward consistently interpreting ambiguous information through a fearful lens are typical of anxiety disorders.

The presence and intensity of these risk factors determine a person's degree of vulnerability: more protective factors and fewer risk factors increase resilience to adversity; conversely, more risk factors and fewer vulnerability factors increase individual vulnerability. However, for this vulnerability to develop into a disorder (or not), it requires interaction with other factors.

This is an original article from the 12th FAROS Report "A look at the mental health of adolescents - Keys to understanding and supporting them".