Smith Ashley R, Jones Emily L, Subar Anni R, Do Quyen B, Kircanski Katharina, Leibenluft Ellen, Brotman Melissa A, Pine Daniel S, Silk Jennifer S
National Institute of Mental Health, Emotion and Development Branch Bethesda Maryland USA.
Department of Psychology University of Denver Denver Colorado USA.
JCPP Adv. 2022 Jun 22;2(3):e12084. doi: 10.1002/jcv2.12084. eCollection 2022 Sep.
Anxiety symptoms often increase in late childhood/early adolescence, particularly among girls. However, few studies examine anxiety-relevant gender differences during anticipation and avoidance of naturalistic experiences during adolescence. The current study uses ecological momentary assessment (EMA) to examine associations among clinical anxiety, gender, anticipation, and attempted avoidance of person-specific anxiety-provoking experiences in youth ages 8-18.
124 youth (73 girls) completed 7 consecutive days of EMA. Seventy participants (42 girls) met criteria for one or more anxiety disorders, while the remaining 54 were healthy controls (31 girls). Participants reported the experience that they were "most worried about happening that day" and completed ratings about that event including whether they attempted to avoid that experience. Multilevel models examined whether diagnostic group (anxious, healthy), gender (boys, girls), or their interaction predicted anticipatory ratings or avoidance of these experiences.
Analyses revealed significant diagnostic group by gender interactions for anticipatory ratings. Specifically, anxious girls reported greater worry and predicted more negative outcomes related to future experiences. However, only a main effect of diagnostic group emerged for attempted avoidance. Finally, anticipatory worry predicted higher rates of attempted avoidance, but this association did not vary by diagnostic group, gender, or their interaction.
These findings extend the literature on the interplay of anticipation and avoidance to person-specific naturalistic experiences in pediatric anxiety. They reveal that anxious girls report more anticipatory anxiety and worry, while avoidance of real-world anxiety-provoking scenarios is a key concern for anxious youth independent of gender. By using EMA to examine person-specific anxiety-inducing experiences we can begin to understand how these processes and experiences unfold in the real world.
焦虑症状在童年晚期/青春期早期往往会增加，尤其是在女孩中。然而，很少有研究考察青少年在预期和回避自然主义体验过程中与焦虑相关的性别差异。本研究采用生态瞬时评估（EMA）来考察临床焦虑、性别、预期以及8至18岁青少年试图回避特定个体引发焦虑的经历之间的关联。
124名青少年（73名女孩）连续7天完成了EMA。70名参与者（42名女孩）符合一种或多种焦虑症的标准，其余54名是健康对照者（31名女孩）。参与者报告了他们“当天最担心发生的事情”，并完成了关于该事件的评分，包括他们是否试图回避该经历。多层次模型考察了诊断组（焦虑、健康）、性别（男孩、女孩）或它们的相互作用是否能预测这些经历的预期评分或回避情况。
分析显示，在预期评分方面，诊断组与性别之间存在显著的交互作用。具体而言，焦虑的女孩报告了更多的担忧，并预测与未来经历相关的负面结果更多。然而，在试图回避方面，仅出现了诊断组的主效应。最后，预期担忧预测了更高的试图回避率，但这种关联在诊断组、性别或它们的相互作用方面并无差异。
这些发现将关于预期和回避相互作用的文献扩展到了儿童焦虑中特定个体的自然主义体验。它们表明，焦虑的女孩报告了更多的预期焦虑和担忧，而回避现实世界中引发焦虑的场景是焦虑青少年的一个关键问题，与性别无关。通过使用EMA来考察特定个体引发焦虑的经历，我们可以开始理解这些过程和经历在现实世界中是如何展开的。
