Intergenerational transmission of anxiety: A comparison of transdiagnostic and disorder-specific pathways

Individuals with a parental history of anxiety disorders are at risk of developing an anxiety disorder. Prior studies have focused on the transmission of specific anxiety disorders across generations (i.e., disorder-specific transmission), often overlooking the possibility that a general tendency to develop various forms of anxiety might be passed from parents to offspring (i.e., transdiagnostic transmission). Our study aimed to investigate whether (a) anxiety disorders are transmitted intergenerationally through disorder-specific or transdiagnostic pathways and (b) different parental transdiagnostic factors differentially predict the offspring's anxiety and the onset of childhood anxiety disorders.

Data were drawn from a subset of participants within a multigenerational family study, focusing specifically on 211 parents (generation 2; G2) and 253 children (generation 3; G3) from families where the first-generation probands either had a diagnosis of moderate/severe major depressive disorder or no lifetime psychiatric disorders. Structural equation modeling was employed to test transdiagnostic and disorder-specific pathways of anxiety transmission, and to compare different G2 transdiagnostic factors in predicting the G3 anxiety factor. Survival analysis was used to examine how different G2 factors predicted the onset of childhood anxiety disorders in G3.

The results indicated that parents transmit general vulnerabilities for developing various forms of anxiety disorders to their offspring (βs = 0.337-0.412, ps = 0.012-0.040), rather than vulnerabilities for specific types of anxiety disorders. Different parental transdiagnostic factors (internalizing, anxiety, and distress) significantly and similarly predicted both the offspring anxiety factor (βs = 0.400-0.469, ps = 0.006 to < 0.001) and the onset age of childhood anxiety disorders (HRs = 2.11-2.71, ps < 0.05).

These results underscore the importance of considering transdiagnostic factors in understanding the intergenerational transmission of anxiety. Targeting these broad underlying vulnerabilities may enhance the effectiveness of interventions and prevention strategies. Future research should further explore potential transdiagnostic genetic, neurobiological, and environmental mechanisms involved in intergenerational anxiety transmission.