Roots of Anxiety: The role of cardiovascular regulation and cortisol in the development of anxiety in early adolecence

Since anxiety problems occur frequently, result in considerable suffering and impairment, and tend to persist over time, it is important to investigate putative underlying mechanisms. The aim of the present thesis was to extend the existing knowledge on the aetiology of anxiety by examining the role of two physiological stress response systems, the autonomic nervous system (ANS; consisting of the sympathetic and parasympathetic/vagal branche) and the hypothalamic-pituitaryadrenal (HPA)-axis, in the development of anxiety in early adolescence. The general idea is that some individuals are characterised by increased (re)activity of these two systems; they are more sensitive to stressors than others (so called ‘hyperaroused’). This increased sensitivity might put them at risk for future anxiety problems. In Chapter 1, the theoretical background and the main research questions were presented. The main research questions were: 1) Is anxiety associated with signs of hyperarousal, whereas depression is not? 2) Are high cortisol levels associated with high anxiety levels and is the persistence of anxiety problems associated with high cortisol levels? 3) Do measures of ANS (re)activity predict future anxiety levels, and are such associations different between boys and girls, and specific for anxiety, as apart from depression? 4) Do cortisol measures predict future anxiety levels, and are distinct developmental pathways of anxiety associated with different cortisol levels? 5) Do assymmetric activation patterns of ANS and HPA-axis activity predict future anxiety levels, are such associations more evident in individuals with high familial vulnerability, and different for boys and girls? To answer these questions the data of the first two assessment waves of TRAILS, a prospective cohort study of Dutch young adolescents, were used.

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