Fear and anxiety: Lessons learned from the Dunedin longitudinal study

Abstract

Four related lines of research on anxiety were reviewed from the ‘Dunedin Study’, an investigation of a representative longitudinal birth cohort of 50-years duration, with 94% retention at the last follow-up. Findings include: (i) Childhood fears deemed evolutionarily-relevant may have different pathways and/or mechanisms underlying their emergence when compared to evolutionarilyneutral fears. (ii) Sequential comorbidity both inside and external to the family of disorders is the rule not the exception, highlighting the importance of developmental history. (iii) The developmental relationship between GAD and MDE is more symmetric that previously assumed, with equal numbers of persons having GAD preceding MDE and MDE preceding GAD. (iv) PTSD in adulthood is influenced by a broad range of childhood risk factors, sequential comorbidity is near universal, and both high-stress life events and mental-disorder history influence the development of PTSD. The implications for epidemiology, nosology, the importance of developmental history, and prevention/treatment options are considered.