New study sheds light on development of anxiety within families

Living together could be the main source of similarity for anxiety between family members, over and above genetic links between them, according to new research from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London.

Published today in The American Journal of Psychiatry, it is the first study to explore the role of genes versus environment on familial patterns of anxiety and in particular how anxiety is passed from parents to adolescent offspring. The findings give hope to parents with anxiety disorders that in spite of genetic influences on the condition, it will not necessarily afflict their children and could be prevented by promoting resilience.

Anxiety disorders are the most common group of disorders, with a lifetime prevalence of 30 per cent. They are associated with a wide array of personal, financial and societal costs, making research in this area a priority. Notably, anxiety disorders tend to start early in life, with a mean age at onset of 11 years. It is therefore important to understand the development of anxiety symptoms in young people.

A unique ‘children of twins’ study design allowed scientists to examine the development of anxiety among around 1,000 families with adolescent offspring. By comparing correlations between children and their parent and contrasting this with correlations between children and their parent’s identical co-twin, researchers could examine the influence of living with one’s parent over and above simply receiving 50 per cent of their genes. In addition, by looking at the size of correlations between children and their twin uncle and aunt from families with identical as compared to non-identical twin families, they could infer the degree to which genetic and environmental factors influence transmission from one generation to another. 

Using measures of anxious personality in parents and anxiety symptoms in their offspring, adult parents from identical twin pairs were found to show greater similarity in anxiety levels to their own adolescent children than their nieces and nephews. This suggests that living together is a key driver of similarity within families for anxiety, even after accounting for genetic similarities.

It is well established that anxiety runs within families and this could result from a number of underlying factors, according to the researchers. Studies have shown that children learn from those around them, so if parents display anxious behaviours this could influence offspring anxiety. However, the reverse is also true, and raising an anxious child can also lead a parent to become more anxious themselves.

Professor Thalia Eley, lead author from the IoPPN at King’s College London, said: ‘Our research shows that even if you have had to cope with high levels of anxiety yourself, it is not inevitable that this will follow in your children. There are many things that can be done at home to prevent or reduce anxiety in children and adolescents. Whilst a natural tendency when your child is anxious is to try to protect them, it can be more helpful to support them in taking small age-appropriate risks. This will teach them that the world is generally a safe place and they can manage situations that initially seem stressful, developing their sense of mastery and in turn promoting resilience.’ 

‘This approach applies equally to families with parents who are not anxious themselves but who have a child who appears to worry more about life than others. Similarly, when events have not gone as well as a child has hoped, it can be helpful to encourage them to consider explanations that do not put them off trying again and that offer them a positive route forwards.’

Robert Freedman, MD Editor of the American Journal of Psychiatry, said: ’This study is a landmark, because it is the first to clearly establish the early transmission of anxiety symptoms from parents to children, not through their shared genetic background, but rather from the way in which anxious parents raise their children. Parents who are anxious can now be counselled and educated on ways to minimise the impact of their anxiety on the child's development.’ 

Professor Eley added that future studies should seek to clarify whether anxiety in children and adolescents elicits anxiety in parents, or whether anxious children and adolescents learn to view the world as threatening because they see their parent interpret it in such a way. ‘This would help us decide whether to focus intervention largely at the parent or child level’, said Professor Eley.

Notes to editors