Trajectories and predictors of anxiety in childhood and adolescence: A 12-year longitudinal study.

OBJECTIVE: This study identified trajectories of anxiety symptoms from childhood to middle adolescence among children characterised as Behaviourally Inhibited (BI) and Behaviourally Uninhibited (BUI) at age 4. How BI and family environment factors predicted trajectories of anxiety and anxiety diagnosis at age 16 was examined. METHODS: This longitudinal study recruited 202 children including BI (n = 102) or BUI (n = 100) aged 3-4 years. Temperament and family environment factors were assessed via observation and parent report at baseline. Child anxiety symptoms were assessed when children were 4, 6, 9, 12, and 16 years old. Child anxiety diagnosis was assessed via diagnostic interview at age 16. RESULTS: Growth mixture modelling identified three distinct trajectories of anxiety symptoms: low-stable (72.87%), moderate-stable (19.58%), and high-increasing (7.55%). Number of maternal lifetime anxiety diagnoses significantly predicted the high-increasing and moderate-stable trajectory relative to the low-stable trajectory. Separate regression analyses showed that number of maternal lifetime anxiety diagnoses when children were aged 4 was significantly associated with the number of child anxiety diagnoses at age 16. BI, maternal overinvolvement, mother-child attachment and maternal negativity at age 4 were not significant predictors of trajectory group nor child anxiety disorders at age 16 after correcting for multiple comparisons. CONCLUSION: Three classes of anxiety symptoms trajectory were identified through childhood and middle adolescence. Maternal anxiety was the most consistent predictor of child anxiety. Targeted prevention programs could be provided for children whose mothers have experienced clinical levels of anxiety.