Trajectories of anxiety and depressive disorders from preschool age to middle childhood and associations with psychosocial and biological factors

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Background: 10-14 % of school-age children (BELLA-Study) and 6-8 % of preschoolers (Haffner et al., 2002) suffer from anxiety or depressive symptoms. Despite their high prevalence, longitudinal studies of anxiety and depression during preschool and school-age remain scarce. To date, neither do we have sufficient knowledge as to whether early emotional symptoms predict later symptoms nor about their precise trajectories.In the current study we plan to remobilize a sample of children with anxiety and/or depressive symptoms and controls matched for SES, age and gender,for a third data-collection point.Aims of the study: 1) Delineate trajectories of emotional symptoms and anxiety disorders/depression.2) Identify psychosocial, neurobiological (HPA-axis-dysregulation) and genetic predictors for the course and outcome of anxiety disorders/depression. 3) Analyze, how these factors interact and whether gender is a moderator.4) To explore how behavioral and autonomic responses to experimentally induced ostracism vary as a function of emotional symptoms and anxiety disorders. Method: At t1, the sample consisted of preschool children, aged 4 to 6. Currently, a second assessment (t2; age 6 to 7) is underway. At t3, N=270 children, now age of 8 to 9 shall be tested again. We aim to assess emotional symptoms drawing on a multi-informant approach (parents, teachers, and children) as well as conducting standardized diagnostic interviews to assess psychopathology. Moreover, we intend to investigate psychosocial factors, such as family environment, negative life events, peer relationships and social competences in detail. We have already collected neuroendocrine as well as genetic data. Additionally, we seek to assess behavioral and cardiovascular responses (e. g. heart-rate variability) on exposure to social exclusion during a school-age version of a well-validated virtual ball toss-game (Cyberball).By using longitudinal statistical models (e.g. Growth Mixture Models, Latent Change Analyses), we analyze the predictive value of the described risk and protective factors on outcome and course of symptoms and disorders.Relevance: The prospective investigation of three assessment points during the key transition period from preschool to school age permits the identification of pathways of symptoms and disorders. Moreover, it enables us to draw conclusions about the etiopathological significance of biological, psychosocial and genetic risk and protective factors, thereby laying the foundation for enhancing preventive and therapeutic approaches.