Vulnerability to anxiety differently predicts cortisol reactivity and state anxiety during a laboratory stressor in healthy girls and boys

Abstract

Background: Children diagnosed with anxiety disorders show altered cortisol and state anxiety reactivity to stressful situations. To date, it remains unclear whether these dysregulations emerge after the pathology or whether they are also detectable in healthy children. If the latter is true, this may provide insight into children's vulnerability to develop clinical anxiety. Various personality factors (anxiety sensitivity, intolerance of uncertainty, perseverative cognitions) increase youth's vulnerability to develop anxiety disorders. This study aimed to examine whether vulnerability to anxiety was associated with cortisol reactivity and state anxiety in healthy youth.

Methods: 114 children (8-12 y/o) were exposed to the Trier Social Stress Test for Children (TSST-C), where saliva samples were collected for cortisol quantification. State anxiety was assessed 20 min before and 10 min after the TSST-C using the state form of the State-Trait Anxiety Inventory for Children. Vulnerability to anxiety was assessed using a composite score of the Childhood Anxiety Sensitivity Index, Intolerance of Uncertainty Scale for Children, and Perseverative Thinking Questionnaire.

Results: Higher vulnerability to anxiety was associated with enhanced cortisol reactivity in boys. Irrespective of vulnerability level, girls reported greater changes in state anxiety in response to the TSST.

Limitations: Given the correlational nature of this study, the directionality of the results remains to be elucidated.

Conclusions: These results indicate that endocrine patterns characterizing anxiety disorders are detectable in healthy boys who exhibit a high level of self-reported vulnerability to anxiety. These results could aid in the early identification of children at risk of developing anxiety disorders.

Keywords: Cortisol reactivity; Sex differences; State anxiety; Trier Social Stress Test for Children; Vulnerability to anxiety; Youth.