Negative Life Events as Predictors of Anxiety Outcomes: An Examination of Event Type
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Negative Life Events as Predictors of Anxiety Outcomes: An Examination of Event Type Elizabeth P. Casline1 · Golda S. Ginsburg2 · John Piacentini3 · Scott Compton4 · Philip Kendall5 Accepted: 23 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Long-term follow-up studies of anxiety treatment have found that greater exposure to negative life events (NLEs) predicts poorer anxiety outcomes, but none have examined whether specific types of NLEs are differentially associated with child outcomes. This study examined the frequency of NLEs and whether specific types of NLEs were associated with increased risk of having an anxiety disorder 6.5 years post randomization. Participants were 319 adolescents and adults, ages 11 to 26 (M = 17), enrolled in Child/Adolescent Anxiety Multimodal Extended Long-term Study. At their first follow-up visit, participants completed a diagnostic interview and a 40-item Life Events Scale that reflected whether specific events occurred since their last post treatment assessment. Life events were categorized into domains (i.e., family, academic, health, and social) via researcher consensus. Participants reported having experienced an average of four NLEs. Participants with an anxiety disorder at follow-up were significantly more likely to have failed a grade in school (OR = 5.9) and experienced a negative change in acceptance by peers (OR = 4.9; ps 0.90) based on a randomly selected 28% (n = 90) of the ADIS administrations (Ginsburg et al. 2018). Remission at longterm follow-up was defined as the absence of all DSM-5 anxiety disorders, obsessive–compulsive disorder, and posttraumatic stress disorder as determined by the ADIS. The Life Events Scales (LES) for children (ages 7–12), adolescents (ages 13–18), and adults (19 +) were completed by study participants and contained 40 overlapping items. The LES is adapted from the widely used Life Events Checklist (Johnson & McCutcheon 1980), contains a list of stressful life events (e.g., divorce of parents/guardians, suspension from school, fighting with friends, getting a job), and asks individuals to indicate events that have occurred since their last study evaluation. The date of last visit was provided for each participant. For each endorsed event, participants were asked to rate the impact as bad (i.e., how scared, sad, or angry it made you) or good (i.e., how pleasant or how happy it made you) using a 9-point scale: 0 (extremely bad) to 4 (neither good nor bad) to 8 (extremely good). Consistent with previous studies, life events were scored as negative if rated by the participant as either “extremely bad”, “very bad”, “somewhat bad” or “slightly bad” (Broeren et al. 2014; Dohrenwend 2006; Espejo et al. 2012; Platt et al. 2016; Tiet et al. 2001). A panel of seven raters comprised of the authors, post-doctoral fellows, and doctoral graduate students independently categorized each of the 40 life events into four domains (see Table 1): family (22 items), academic (4 items), health (2 items) and social (12
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