Network tools identify early signs of anxiety

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Science Translational Medicine  12 Sep 2018:
Vol. 10, Issue 458, eaav0336
DOI: 10.1126/scitranslmed.aav0336


Novel network analyses identify constellations of childhood symptoms that predict anxiety disorders and depression during adolescence and young adulthood.

Research has shown that behavioral and emotional symptoms during childhood and adolescence predict the onset of adult psychopathology, but how the emergence of these symptoms is connected and whether single behaviors or clusters of symptoms are associated with adult psychopathology is unknown. Rouquette et al. applied a new network analytical approach to examine emotional and behavior symptom constellations in childhood and assessed how these networks predicted anxiety and depression diagnoses.

Caregivers of 932 girls in Quebec completed the Social Behavior Questionnaire (SBQ) yearly between 6 and 12 years of age, answering queries about internalizing, disruptive, and prosocial behaviors. At ages 15 and 22, the participants were evaluated for diagnoses of anxiety disorders and major depression using the Diagnostic Interview Schedule (DSM-III-R). With caregiver answers on the SBQ, emotional and behavioral symptoms at age 6, 8, and 10 were characterized to determine network strength of symptom clusters and connectivity between symptoms, as well as network associations with adolescent and young adult outcomes. Not being liked by other children, disobedient behavior, and irritability were positively related to future diagnoses of anxiety disorders but not depression. Interestingly, networks were stable across ages 6, 8, and 10 and revealed that irritability, blaming others, not being liked, often crying, and being solitary were key symptoms, as they consistently connected disruptive and internalizing symptom clusters in childhood. The authors termed these symptoms that connected internalizing and disruptive behaviors “bridge symptoms.” Bridge symptoms could be critical to understanding childhood processes that lead to long-term anxiety and may present early intervention targets.

As noted by the authors, extending these findings to a sample of boys will be crucial for better understanding why more females than males are diagnosed with anxiety and depression during adolescence and young adulthood. The analytical approach of network analyses provides a new perspective for putting single behaviors into co-occurring clusters and also demonstrates how linking behaviors together can inform diagnostic outcomes.

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