Across the pooled NCS-R and NLAAS samples, a total of 1,939 individuals reported one or more anxiety disorders. Of these, the majority reported that at least one of these anxiety disorders had an onset prior to age 18 (1,281/1,939). The mean age of onset reported across all anxiety disorders was 17.10 (SE = 0.35). As indicates, significant age of onset differences were found across the three ethnicity/nativity groups. The mean age of onset across all anxiety disorders was in adolescence for U.S.-born Latinos (M = 15.2) and U.S.-born whites (M = 16.9). In contrast, foreign-born Latinos had a mean age of onset in early adulthood (M = 22.6). These group differences were statistically significant (F2,92 = 6.56, p < .01). When individual anxiety disorders were examined, statistical tests revealed significant differences for GAD and social phobia. In both cases, foreign-born Latinos reported ages of onset that were, on average, between 5 and 10 years later than those reported by U.S. born Latinos and U.S. born whites. On the other hand, across all three ethnicity/nativity groups, social phobia had the earliest age of onset of all anxiety disorders, while GAD had the latest age of onset.
also shows significant differences in the proportion of anxiety disorders which are diagnosed in childhood. U.S.-born Latinos (68.3%) and U.S.-born non-Latino whites (65.5%) reported a higher rate of childhood-onset anxiety disorders relative to foreign-born Latinos (53.4%; F2,92 = 4.79, p <.05). Significant ethnicity/nativity differences in rates of childhood-onset prevalence were found for agoraphobia (F2,73 = 6.59, p < .01) panic disorder (F2,77 = 3.63, p < .05), and social phobia (F2,87= 5.83, p < .01). In general, foreign-born Latinos were the least likely to have an anxiety disorder with a childhood-onset.
focuses exclusively on individuals diagnosed with one or more lifetime anxiety disorders. Within this subsample, demographic and clinical characteristics are compared between those individuals who reported childhood- versus adult-onset anxiety disorders. These onset comparisons were made separately for each of the three ethnicity/nativity groups. Relative to those with a childhood onset, individuals with adult onset anxiety disorders were more likely to be female among both the U.S.-born white (F1,42=9.76, p<.01) and foreign-born Latino groups (F1,45=4.16, p<.05). Differences in marital status were found across child- and adult-onset groups among U.S.-born whites (F1.71,71.67=22.07, p<.001). Among foreign-born Latinos, there were differences in income (F 2.70,121.65 = 3.57, p<.05) and employment status (F 1.94, 87.15 = 4.03, p<.05) between childhood and adult onset groups. Foreign-born Latinos with adult-onset anxiety disorders were more likely to have lower incomes and less likely to be employed than their counterparts with a childhood onset anxiety disorder.
Prevalence of selected clinical characteristics across child- and adult-onset groups are also presented in for each of the three ethnicity/nativity groups. There were significant differences in the number of past year anxiety disorders between those with childhood-onset anxiety disorders and those with adult onset among U.S.-born non-Latino whites and foreign-born Latinos (F2.64,110.99=9.21, p<.0001 and F2.21, 99.43=5.28, p<.01) with more individuals who had a childhood-onset anxiety disorder having at least one past year anxiety disorder. Moderate to severe past year impairment associated with an anxiety disorder was more prevalent in those with childhood onset compared to those with adult onset among U.S.-born non-Latino whites (F1,42=26.27, p<.0001) and foreign-born Latinos (F1,45 = 4.69, p < .05)
displays the odds ratios for comorbid lifetime depressive and substance use disorders estimated using logistic regression models. The main effects model included age, sex, anxiety disorder onset category, and ethnicity/nativity categories. This model indicated that individuals with a lifetime anxiety disorder were more than six times as likely to have a lifetime depressive disorder compared to those without anxiety disorder for both onset groups. Similarly, about a three-fold risk for substance use disorders was associated with individuals with a lifetime anxiety disorder, regardless of age of onset. Additionally, the main effects model indicated that relative to U.S.-Born Whites, foreign-born Latino’s were less likely to report substance use disorders (OR = 0.28, 95%, CI = (0.190, 0.414)).
also displays a series of interaction models that were conducted to test differences in the likelihood of having a comorbid depressive or substance use disorder across onset groups and ethnicity/nativity categories, after controlling for sex and age. First, comparisons were made between childhood- vs. adult-onset groups within each ethnicity/nativity group, using the childhood-onset category as the reference group for each individual comparison. No differences between childhood- vs. adult- onset groups were found within ethnicity/nativity groups for comorbid depressive or substance use disorders. Next, comparisons were made between childhood- vs. adult-onset categories across each ethnicity/nativity group, using the adult onset category as the reference group for each individual comparison. Relative to foreign-born Latinos with adult-onset anxiety disorders, U.S. born Latinos with childhood-onset anxiety were more likely to report a comorbid substance abuse disorder (OR = 5.52, 95%, CI = (1.586, 19.241)). Additionally, relative to foreign-born Latinos with adult onset anxiety disorders, U.S. born Whites with childhood-onset anxiety were more likely to report a comorbid substance use disorder (OR = 4.82, 95%, CI (1.702, 13.632)). No significant differences in risk for comorbid depressive disorders were found across ethnicity/nativity groups. Finally, comparisons were made between childhood-onset categories across the different ethnicity/nativity groups. The risk for comorbid depressive and substance use disorders was not significantly different when comparing childhood-onset groups across ethnicity/nativity categories.
shows the mean number of lifetime psychiatric disorders, comorbidity rates, and order of onset for anxiety and non-anxiety (depressive and substance) disorders among individuals with childhood-onset anxiety disorders across ethnicity/nativity categories. Reported findings have been adjusted for age and sex differences across the groups. Individuals with childhood-onset anxiety disorders reported somewhere between 2.6 (foreign-born Latinos) and 2.9 (U.S. born Latinos) lifetime disorders, and these differences were not significant across the three ethnicity/nativity groups.
Between one quarter and one third of individuals with a childhood-onset anxiety disorder reported no comorbidity, at least among the 13 disorders assessed. Across ethnicity/nativity groups, rates for comorbid anxiety disorders (i.e., more than one lifetime anxiety disorder) among individuals with childhood-onset anxiety disorders ranged from 35.2% to 37.9%. Rates of comorbid depressive disorders ranged from 49.5% to 50.3%, while rates of comorbid substance use disorders ranged from 19.3% to 27.6%. A smaller proportion of individuals with childhood-onset anxiety disorders had comorbid eating disorders (2.4% to 8.0%). Differences in comorbidity rates were not significant across ethnic/nativity groups.
The majority of the individuals with childhood-onset anxiety disorders who also reported a comorbid depressive and substance disorder reported that the anxiety disorder preceded these comorbid disorders. This pattern was consistent across all three ethnicity/nativity groups.