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Risiko- und Schutzfaktoren generalisierter Ängstlichkeit im Kindes- und Jugendalter

Ergebnisse der BELLA-Kohortenstudie

Published Online:February 11, 2016https://doi.org/10.1026/0942-5403/a000185

Abstract

Zusammenfassung. Die generalisierte Angststörung bei Kindern und Jugendlichen weist eine Prävalenz von 2 % und ein Erstmanifestationsalter von 8.5 Jahren auf. Anhand der Daten der BELLA-Kohortenstudie wurden Einflüsse ausgewählter Risiko- und Schutzfaktoren auf das Auftreten und die Entwicklung von Symptomen generalisierter Angststörung (generalisierte Ängstlichkeit) untersucht. Mit latenten Wachstumsmodellen und linearen Regressionen wurden die Angaben von n = 1 469 Teilnehmern (11 bis 17 Jahre) zu drei Messzeitpunkten analysiert. Zu Studienbeginn wirkte die elterliche Ängstlichkeit als Risikofaktor und das Selbstwertgefühl der Kinder und Jugendlichen als Schutzfaktor auf die generalisierte Ängstlichkeit. Initiale elterliche Ängstlichkeit wirkte auch nachhaltig auf die Veränderung generalisierter Ängstlichkeit über den Studienverlauf. Weiterhin ging eine Verbesserung des Selbstwertgefühls über den Studienverlauf mit einem Abfall generalisierter Ängstlichkeit einher. Einflüsse der potentiellen Schutzfaktoren elterliche Fürsorge und soziale Unterstützung lagen nicht vor. Obwohl nur geringe Effekte gefunden wurden, ist das Selbstwertgefühl für die klinische Arbeit mit Kindern und Jugendlichen mit generalisierter Angststörung interessant.


Risk and Protective Factors for Symptoms of General Anxiety Disorder in Children and Adolescents: Results of the BELLA Cohort Study

Abstract. The prevalence of generalized anxiety disorder is approximately 2 % among children and adolescents, and the age of onset is at about 8.5 years. Considering the individual and societal burden of psychiatric disorders, early interventions for individuals at risk and targeted interventions are reasonable. To provide necessary information for prevention and intervention, research on risk and protective factors of specific psychiatric disorders is needed. This study aimed to investigate the risk and protective factors of symptoms of generalized anxiety disorder cross-sectionally and longitudinally. Influences of parental anxiety as a risk factor and of self-esteem, parental care, and social support as protective factors on generalized anxiety in children and adolescents were analyzed. The longitudinal BELLA study is the mental health module of the German National Health Interview and Examination Survey among children and adolescents (KiGGS). Data of 1,469 participants aged 11 – 17 years from three measurement points (covering a period of 2 years) were analyzed. Latent growth and linear regression models controlling for age, sex, socioeconomic status, as well as comorbid depressive symptoms were calculated. Parental anxiety at baseline predicted symptoms of generalized anxiety disorder in children and adolescents at baseline as well as over time. Further, the protective factor self-esteem at baseline was associated with fewer symptoms of generalized anxiety disorder at baseline. Additionally, positive change in self-esteem was associated with the development of fewer symptoms of generalized anxiety disorder over time. However, no effects at all were found for parental care and social support. In terms of control variables, girls compared with boys and older compared with younger children and adolescents had more symptoms of generalized anxiety disorder. Moreover, symptoms of depression and generalized anxiety disorder were positively connected, initially as well as concerning their changes over time. Findings confirm that parental anxiety is a risk factor for the development of generalized anxiety in their children. Further, findings confirm that self-esteem may serve as a protective factor for generalized anxiety in children and adolescents. However, effects were only small in our general population sample and the longitudinal data covered only a period of 2 years. Thus, changes over time were only small. In terms of limitations, this study could not consider stressful or traumatic life events and parental anxiety was assessed by only one item. Further, we analyzed only data gathered by questionnaires, but did not conduct psychiatric diagnostics. The protective factor self-esteem may be of interest concerning clinical work with children and adolescents suffering from generalized anxiety disorder.

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