The Effects of Childhood Adversity on Anxiety in People with Mood Disorders

Abstract

Mood and anxiety disorders are among the leading causes of disability worldwide. Both childhood adversity and the presence of an anxiety disorder contribute to unfavorable outcomes for those who have mood disorders. The chronicity of anxiety is higher in the general population with experiences of childhood adversity; however, it is unclear whether the severity and persistence of anxiety in people with mood disorders increase with higher levels of adversity. In addition, prospective assessment of anxiety at multiple time points is not common in the literature. (1) Our primary hypothesis was that people with mood disorders who experienced greater levels of childhood adversity will have a higher average anxiety score over the six months preceding their first assessment. (2) We also hypothesized that people with mood disorders who experienced greater levels of childhood adversity will have a higher number of lifetime anxiety and related disorders, and (3) will prospectively report more anxiety symptoms. We included participants with major depressive disorder, bipolar I disorder, or bipolar II disorder, confirmed by the Structured Clinical Interview for DSM-5 (SCID-5). During the initial assessment, we determined the participant's mood and anxiety disorders. We also administered The Longitudinal Interval Follow-Up Evaluation (LIFE), The Childhood Experience of Care and Abuse (CECA), and The Screen for Adult Anxiety Related Disorders (SCAARED). The LIFE interview was used to derive both the average mood disorder severity score and average anxiety score over the preceding six months. The CECA was used to create the childhood adversity score. We used the SCAARED monthly following the initial assessment to measure participants’ anxiety prospectively. Childhood adversity was found to have no effect on the participants’ average anxiety measured retrospectively over the previous six months or the severity of participants’ anxiety measured prospectively. Nor was it found to have an effect on the number of anxiety disorders per participant. It is possible that we did not find an effect of childhood adversity on anxiety severity among people with mood disorders for several reasons. Firstly, participants in our sample experienced very little childhood adversity. Secondly, most participant scored low on the anxiety measures. This study is unique in that it captured a detailed view of six months of participants' experiences with mood and anxiety disorders and because anxiety was also assessed prospectively. The main limitation of our study was a small sample size. Future studies on childhood adversity and anxiety in people with mood disorders should focus on collecting larger samples.