Anxiety vulnerability and stress reactivity: a gendered perspective

Anxiety disorders are common among adolescents, with girls twice as likely to be diagnosed as boys. Stress is a known risk factor for anxiety disorders, and researchers have studied the physiological stress system as a potential correlate of anxiety disorders in youth.

The hypothalamic-pituitary-adrenal (HPA) axis is activated in response to stress, and cortisol is the main end product. Cortisol reactivity to stress has been studied in children with anxiety disorders, but the findings have been mixed. Some studies have shown increased reactivity, while others have found no difference compared to healthy children.

Several factors have been proposed to explain the mixed findings regarding cortisol reactivity in children with anxiety disorders, including sex, puberty status, severity of anxiety symptoms, and presence of comorbid psychopathologies. In healthy children, cortisol reactivity has been shown to be modulated by trait anxiety, sex, and puberty status.

Many personality factors, such as anxiety sensitivity, intolerance to uncertainty, perseverative cognitions, and trait anxiety, have been identified as vulnerability factors for anxiety disorders in youth. These factors have been shown to predict psychological distress and lower hair cortisol concentrations changes in healthy youth during the COVID-19 pandemic. However, the effect of these personality traits on cortisol reactivity to an acute stressor has not been well-studied, according to sciencedirect.

The current study examined the association between anxiety vulnerability and state anxiety as well as cortisol reactivity to an experimental stressor in healthy children. The researchers hypothesized that they would find a positive association between anxiety vulnerability and state anxiety reactivity and between vulnerability to anxiety and cortisol reactivity.

They also hypothesized that these associations would be stronger in girls than in boys.

The study included 114 healthy children aged 8-12 years. Anxiety vulnerability was assessed using a composite score of anxiety sensitivity, intolerance to uncertainty, perseverative cognitions, and trait anxiety. State anxiety was assessed using self-report questionnaires before and after the experimental stressor, which was a public speaking task. Cortisol was measured in saliva before and after the stressor.

The results showed that anxiety vulnThe findings suggest that children with high anxiety vulnerability may be more likely to experience increased state anxiety and cortisol reactivity in response to stress. These findings may help to identify children at risk for developing anxiety disorders in the future.erability was positively associated with state anxiety reactivity and cortisol reactivity to the stressor. These associations were stronger in girls than in boys.