Rany Abend1, Mira A Bajaj1, Daniel D L Coppersmith2, Katharina Kircanski1, Simone P Haller1, Elise M Cardinale1, Giovanni A Salum3,4, Reinout W Wiers5, Elske Salemink6, Jeremy W Pettit7, Koraly Pérez-Edgar8, Eli R Lebowitz9, Wendy K Silverman9, Yair Bar-Haim10, Melissa A Brotman1, Ellen Leibenluft1, Eiko I Fried11, Daniel S Pine1. 1. Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA. 2. Department of Psychology, Harvard University, Cambridge, MA, USA. 3. National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil. 4. Department of Psychiatry, Universidad Federal do Rio Grande do Sul, Porto Alegre, Brazil. 5. Addiction Development and Psychopathology (ADAPT)-lab, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands. 6. Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands. 7. Florida International University, Miami, FL, USA. 8. The Pennsylvania State University, University Park, PA, USA. 9. Yale University, New Haven, CT, USA. 10. Tel Aviv University, Tel Aviv, Israel. 11. Department of Clinical Psychology, Leiden University, Leiden, the Netherlands.
Abstract
BACKGROUND: While taxonomy segregates anxiety symptoms into diagnoses, patients typically present with multiple diagnoses; this poses major challenges, particularly for youth, where mixed presentation is particularly common. Anxiety comorbidity could reflect multivariate, cross-domain interactions insufficiently emphasized in current taxonomy. We utilize network analytic approaches that model these interactions by characterizing pediatric anxiety as involving distinct, inter-connected, symptom domains. Quantifying this network structure could inform views of pediatric anxiety that shape clinical practice and research. METHODS: Participants were 4964 youths (ages 5-17 years) from seven international sites. Participants completed standard symptom inventory assessing severity along distinct domains that follow pediatric anxiety diagnostic categories. We first applied network analytic tools to quantify the anxiety domain network structure. We then examined whether variation in the network structure related to age (3-year longitudinal assessments) and sex, key moderators of pediatric anxiety expression. RESULTS: The anxiety network featured a highly inter-connected structure; all domains correlated positively but to varying degrees. Anxiety patients and healthy youth differed in severity but demonstrated a comparable network structure. We noted specific sex differences in the network structure; longitudinal data indicated additional structural changes during childhood. Generalized-anxiety and panic symptoms consistently emerged as central domains. CONCLUSIONS: Pediatric anxiety manifests along multiple, inter-connected symptom domains. By quantifying cross-domain associations and related moderation effects, the current study might shape views on the diagnosis, treatment, and study of pediatric anxiety.
BACKGROUND: While taxonomy segregates anxiety symptoms into diagnoses, patients typically present with multiple diagnoses; this poses major challenges, particularly for youth, where mixed presentation is particularly common. Anxiety comorbidity could reflect multivariate, cross-domain interactions insufficiently emphasized in current taxonomy. We utilize network analytic approaches that model these interactions by characterizing pediatric anxiety as involving distinct, inter-connected, symptom domains. Quantifying this network structure could inform views of pediatric anxiety that shape clinical practice and research. METHODS: Participants were 4964 youths (ages 5-17 years) from seven international sites. Participants completed standard symptom inventory assessing severity along distinct domains that follow pediatric anxiety diagnostic categories. We first applied network analytic tools to quantify the anxiety domain network structure. We then examined whether variation in the network structure related to age (3-year longitudinal assessments) and sex, key moderators of pediatric anxiety expression. RESULTS: The anxiety network featured a highly inter-connected structure; all domains correlated positively but to varying degrees. Anxiety patients and healthy youth differed in severity but demonstrated a comparable network structure. We noted specific sex differences in the network structure; longitudinal data indicated additional structural changes during childhood. Generalized-anxiety and panic symptoms consistently emerged as central domains. CONCLUSIONS: Pediatric anxiety manifests along multiple, inter-connected symptom domains. By quantifying cross-domain associations and related moderation effects, the current study might shape views on the diagnosis, treatment, and study of pediatric anxiety.
Authors: William W Hale; Quinten Raaijmakers; Peter Muris; Anne van Hoof; Wim Meeus Journal: J Am Acad Child Adolesc Psychiatry Date: 2008-05 Impact factor: 8.829
Authors: Rany Abend; Diana Burk; Sonia G Ruiz; Andrea L Gold; Julia L Napoli; Jennifer C Britton; Kalina J Michalska; Tomer Shechner; Anderson M Winkler; Ellen Leibenluft; Daniel S Pine; Bruno B Averbeck Journal: Elife Date: 2022-04-27 Impact factor: 8.713
Authors: Anita Harrewijn; Elizabeth R Kitt; Rany Abend; Chika Matsumoto; Paola Odriozola; Anderson M Winkler; Ellen Leibenluft; Daniel S Pine; Dylan G Gee Journal: Behav Brain Res Date: 2020-11-04 Impact factor: 3.332