Developmental pathways in youth anxiety disorders: potential mechanisms for (mal)adapting to crises and improving treatment - a commentary on Klein et al. (2023)

Abstract

The ability to cope with threats is crucial in today's troubling times, especially for young people who are still developing coping mechanisms. Psychopathology and the development of anxiety disorders can be viewed as a failure to adapt to changing demands. We draw on a study by Klein et al. (Journal of Child Psychology and Psychiatry, 2023), which showed that anxious youths exhibited stronger conditioned fear responses and, during delayed extinction learning, greater electrocortical differences between threat and safety stimuli. Interestingly, these signatures of learning processes were also associated with treatment outcomes. We argue for developmentally sensitive research: Individual learning and associated cognitive-affective changes are strongly age-dependent and represent the key mechanism for both anxiety development and treatment. They also interact with social and environmental factors. Based on the call for age- and context-sensitive research, future research should focus on establishing reliable risk profiles that consider a variety of factors to enable evidence-based, individualized treatment decisions.