Trends in anxiety among adults in the United States, 2008-2018: Rapid increases among young adults

Renee D Goodwin, Andrea H Weinberger, June H Kim, Melody Wu, Sandro Galea, Renee D Goodwin, Andrea H Weinberger, June H Kim, Melody Wu, Sandro Galea

Abstract

Introduction: In a time of global uncertainty, understanding the psychological health of the American public is imperative. There are no current data on anxiety trends among adults in the United States (US) over time. This study aimed to investigate prevalence of anxiety among US adults from 2008 to 2018.

Methods: Data from the National Survey on Drug Use and Health (NSDUH), which is an annual, cross-sectional survey on substance use and mental health in the US, were analyzed in 2020. Prevalence of past-month anxiety was estimated among those ages ≥18, by survey year from 2008 to 2018. Time trends were tested using logistic regression.

Results: Anxiety increased from 5.12% in 2008 to 6.68% in 2018 (p < 0.0001) among adult Americans. Stratification by age revealed the most notable increase from 7.97% to 14.66% among respondents 18-25 years old (p < 0.001), which was a more rapid increase than among 26-34 and 35-49 year olds (differential time trend p < 0.001). Anxiety did not significantly increase among those ages 50 and older. Anxiety increased more rapidly among those never married and with some college education, relative to their respective counterparts. Apart from age, marital status and education, anxiety increased consistently among sociodemographic groups.

Conclusions: Anxiety is increasing among adults under age 50 in the US, with more rapid increase among young adults. To prepare for a healthier adulthood and given direct and indirect (via 24/7 media) exposure to anxiety-provoking world events, prophylactic measures that can bolster healthy coping responses and/or treatment seeking seem warranted on a broad scale.

Keywords: Anxiety; Epidemiology; Mental health; NSDUH; Nervousness.

Conflict of interest statement

None declared.

Copyright © 2020 Elsevier Ltd. All rights reserved.

Figures

Fig. 1
Fig. 1
Prevalence of past-month anxiety from 2008 to 2018 (NSDUH, US adults ages 18 years and older)a. Abbreviations: aOR, adjusted odds ratio; CI, confidence interval; NSDUH, National Survey on Drug Use and Health. aAnxiety was operationalized as self-reported nervousness in the past month most of the time or all of the time. Note: Odds ratio for calendar yearly linear trend was adjusted for age, gender, race/ethnicity, income, marital status, and educational attainment.
Fig. 2
Fig. 2
Prevalence of past-month anxiety by age from 2008 to 2018 (NSDUH, US adults ages 18 years and older)a. Abbreviations: aOR, adjusted odds ratio; CI, confidence interval; NSDUH, National Survey on Drug Use and Health. aAnxiety was operationalized as self-reported nervousness in the past month most of the time or all of the time. Note: Odds ratio for calendar yearly linear trend was adjusted for gender, race/ethnicity, income, marital status, and educational attainment.

References

    1. American Psychological Association . Stress in America™ Survey. American Psychological Association; Washington, DC: 2014. Stress in America: are teens adopting adults' stress habits?
    1. American Psychological Association . Stress in AmericaTM Survey. American Psychological Association; Washington, DC: 2016. Stress in America: the impact of discrimination.
    1. American Psychological Association . Stress in America™ Survey. American Psychological Association; Washington, DC: 2017. Stress in America: coping with change.
    1. American Psychological Association . Stress in America™ Survey. American Psychological Association; Washington, DC: 2019. Stress in America: stress and current events.
    1. Barthorpe A., Winstone L., Mars B., Moran P. Is social media screen time really associated with poor adolescent mental health? A time use diary study. J. Affect. Disord. Advance online publication. 2020 doi: 10.1016/j.jad.2020.05.106.
    1. Bittner A., Goodwin R.D., Wittchen H.U., Beesdo K., Hofler M., Lieb R. What characteristics of primary anxiety disorders predict subsequent major depressive disorder? J. Clin. Psychiatr. 2004;65(5):618–626. quiz 730.
    1. Blom V., Kallings L.V., Ekblom B., Wallin P., Andersson G., Hemmingsson E., Ekblom O., Soderling J., Ekblom Bak E. Self-reported general health, overall and work-related stress, loneliness, and sleeping problems in 335,625 Swedish adults from 2000 to 2016. Int. J. Environ. Res. Publ. Health. 2020;17(2)
    1. Cacioppo S., Capitanio J.P., Cacioppo J.T. Toward a neurology of loneliness. Psychol. Bull. 2014;140(6):1464–1504.
    1. Case A., Deaton A. Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. Proc. Natl. Acad. Sci. U.S.A. 2015;112(49):15078–15083.
    1. Center for Behavioral Health Statistics and Quality . Substance Abuse and Mental Health Services Administration; Rockville, MD: 2018. 2017 National Survey on Drug Use and Health: Methodological Summary and Definitions.
    1. Christiana J.M., Gilman S.E., Guardino M., Mickelson K., Morselli P.L., Olfson M., Kessler R.C. Duration between onset and time of obtaining initial treatment among people with anxiety and mood disorders: an international survey of members of mental health patient advocate groups. Psychol. Med. 2000;30(3):693–703.
    1. Curtin S.C., Tejada-Vera B. Mortality among adults aged 25 and over by marital status: United States, 2010–2017. NCHS Health E-Stat. 2019
    1. Elran-Barak R., Mozeikov M. One month into the reinforcement of social distancing due to the COVID-19 outbreak: subjective health, health behaviors, and loneliness among people with chronic medical conditions. Int. J. Environ. Res. Publ. Health. 2020;17(15):5403.
    1. Goodwin R.D. Anxiety disorders and the onset of depression among adults in the community. Psychol. Med. 2002;32(6):1121–1124.
    1. Goodwin R.D. The prevalence of panic attacks in the United States: 1980 to 1995. J. Clin. Epidemiol. 2003;56(9):914–916.
    1. Goodwin R.D., Fergusson D.M., Horwood L.J. Association between anxiety disorders and substance use disorders among young persons: results of a 21-year longitudinal study. J. Psychiatr. Res. 2004;38(3):295–304.
    1. Goodwin R.D., Fergusson D.M., Horwood L.J. Early anxious/withdrawn behaviours predict later internalising disorders. JCPP (J. Child Psychol. Psychiatry) 2004;45(4):874–883.
    1. Goodwin R.D., Gorman J.M. Psychopharmacologic treatment of generalized anxiety disorder and the risk of major depression. Am. J. Psychiatr. 2002;159(11):1935–1937.
    1. Goodwin R.D., Olfson M. Treatment of panic attack and risk of major depressive disorder in the community. Am. J. Psychiatr. 2001;158(7):1146–1148.
    1. Hollis C., Livingstone S., Sonuga-Barke E. The role of digital technology in children and young people's mental health–a triple-edged sword? JCPP (J. Child Psychol. Psychiatry) 2020;61(8):837–841.
    1. Holt-Lunstad J., Smith T.B., Baker M., Harris T., Stephenson D. Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspect. Psychol. Sci. 2015;10(2):227–237.
    1. Hoyt L.T., Zeiders K.H., Chaku N., Toomey R.B., Nair R.L. Young adults' psychological and physiological reactions to the 2016 U.S. presidential election. Psychoneuroendocrinology. 2018;92:162–169.
    1. Igbokwe C.C., Ejeh V.J., Agbaje O.S., Umoke P.I.C., Iweama C.N., Ozoemena E.L. Prevalence of loneliness and association with depressive and anxiety symptoms among retirees in North central Nigeria: a cross-sectional study. BMC Geriatr. 2020;20(1):153.
    1. Iza M., Olfson M., Vermes D., Hoffer M., Wang S., Blanco C. Probability and predictors of first treatment contact for anxiety disorders in the United States: analysis of data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) J. Clin. Psychiatr. 2013;74(11):1093–1100.
    1. Kaplan R.M., Kronick R.G. Marital status and longevity in the United States population. J. Epidemiol. Community Health. 2006;60(9):760–765.
    1. Kessler R.C., Olfson M., Berglund P.A. Patterns and predictors of treatment contact after first onset of psychiatric disorders. Am. J. Psychiatr. 1998;155(1):62–69.
    1. McEwen B.S. Effects of stress on the developing brain. Cerebrum. 2011;2011 14-14.
    1. Olafiranye O., Jean-Louis G., Zizi F., Nunes J., Vincent M. Anxiety and cardiovascular risk: review of epidemiological and clinical evidence. Mind Brain. 2011;2(1):32–37.
    1. Olfson M., Wang S., Wall M., Marcus S.C., Blanco C. Trends in serious psychological distress and outpatient mental health care of US adults. JAMA Psychiatry. 2019;76(2):152–161.
    1. Petitte T., Mallow J., Barnes E., Petrone A., Barr T., Theeke L. A systematic review of loneliness and common chronic physical conditions in adults. Open Psychol. J. 2015;8(Suppl. 2):113–132.
    1. Piccolo L.R., Noble K.G. Perceived stress is associated with smaller hippocampal volume in adolescence. Psychophysiology. 2018;55(5)
    1. Rendall M.S., Weden M.M., Favreault M.M., Waldron H. The protective effect of marriage for survival: a review and update. Demography. 2011;48(2):481–506.
    1. Riehm K.E., Feder K.A., Tormohlen K.N., Crum R.M., Young A.S., Green K.M., Pacek L.R., La Flair L.N., Mojtabai R. Associations between time spent using social media and internalizing and externalizing problems among US youth. JAMA Psychiatry. 2019;76(12):1266–1273.
    1. Ringbäck Weitoft G., Rosén M. Is perceived nervousness and anxiety a predictor of premature mortality and severe morbidity? A longitudinal follow up of the Swedish survey of living conditions. J. Epidemiol. Community Health. 2005;59(9):794–798.
    1. Roy-Byrne P.P., Davidson K.W., Kessler R.C., Asmundson G.J., Goodwin R.D., Kubzansky L., Lydiard R.B., Massie M.J., Katon W., Laden S.K., Stein M.B. Anxiety disorders and comorbid medical illness. Gen. Hosp. Psychiatr. 2008;30(3):208–225.
    1. Saleh A., Potter G.G., McQuoid D.R., Boyd B., Turner R., MacFall J.R., Taylor W.D. Effects of early life stress on depression, cognitive performance and brain morphology. Psychol. Med. 2017;47(1):171–181.
    1. Taha F., Lipsitz J.D., Galea S., Demmer R.T., Talley N.J., Goodwin R.D. Anxiety disorders and risk of self-reported ulcer: a 10-year longitudinal study among US adults. Gen. Hosp. Psychiatr. 2014;36(6):674–679.
    1. Wang P.S., Berglund P.A., Olfson M., Kessler R.C. Delays in initial treatment contact after first onset of a mental disorder. Health Serv. Res. 2004;39(2):393–415.
    1. Weinberger A.H., Gbedemah M., Martinez A.M., Nash D., Galea S., Goodwin R.D. Trends in depression prevalence in the USA from 2005 to 2015: widening disparities in vulnerable groups. Psychol. Med. 2018;48(8):1308–1315.
    1. Wittchen H.U., Beesdo K., Bittner A., Goodwin R.D. Depressive episodes--evidence for a causal role of primary anxiety disorders? Eur. Psychiatr. 2003;18(8):384–393.
    1. Zeiders K.H., Nair R.L., Hoyt L.T., Pace T.W., Cruze A. Latino early adolescents' psychological and physiological responses during the 2016 US presidential election. Cult. Divers Ethnic Minor. Psychol. 2019;26(2):169–175.

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