Childhood cognitive performance and risk of generalized anxiety disorder

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Abstract
Background Perception of control over one's environment, particularly when faced with an ambiguous situation, has been identified as a critical cognitive process involved in worry and generalized anxiety disorder (GAD). Similarly, it is thought that individuals with lower cognitive skills feel less in control, and do not cope as well as individuals with higher cognitive skills. This study tests the hypothesis that individuals with higher cognitive skills are less likely to develop a lifetime diagnosis of GAD, and considers onset in three developmental periods: childhood, adolescence and adulthood. Methods Survival analysis and multivariate regression models were used to evaluate the relationship between cognitive performance at age seven, and DSM-IV diagnosis of GAD. Study participants were 689 individuals in their mid-30s, who had been followed since birth as part of the National Collaborative Perinatal Project in Providence, RI, USA. Results A 15-point (1 SD) advantage in childhood cognitive performance was significantly associated with a 50% reduced risk of lifetime GAD and an 89 and 57% reduction in risk of GAD in childhood and adolescence, respectively, after adjusting for relevant covariates including socio-economic status and parent history of mental health problems. These results were not affected by behavioural inhibition or learning disabilities in childhood. Conclusions Childhood cognitive performance is associated with a diagnosis of GAD in childhood and adolescence. Further research on the association between childhood cognitive performance and GAD is warranted.