Social skills and symptoms of anxiety disorders from preschool to adolescence: a prospective cohort study

Abstract

Background Prior research, mostly cross-sectional or prospective studies with short follow-up periods, has indicated that childhood anxiety is associated with difficulties with social interaction. However, the etiological role of social skills in the development of anxiety in childhood remains unknown. Moreover, it is not known whether childhood anxiety impedes the development of age-appropriate social skills.

Methods The relation between anxiety and social skills was, therefore, examined in two birth cohorts of children who were assessed biennially from the ages of 4 to 14 years (n = 1,043). Semistructured psychiatric diagnostic interviews of children (from age 8) and parents were used to measure symptoms of separation, generalized, and social anxiety disorders as well as specific phobias. Social skills were measured through the parent-reported Social Skills Rating System. A random intercept cross-lagged panel model was used to analyze the data, adjusting for observed time-variant covariates (emotion regulation, secure attachment, bullying victimization, and global self-esteem) and all unobserved time-invariant confounding effects.

Results Reduced social skills predicted increased symptoms of anxiety at ages 8, 10, and 12 (β = −.26, β = −.17, and β = −.15, respectively), whereas an increased number of anxiety symptoms did not forecast changes in social skills.

Conclusions The findings suggest that reduced social skills may be involved in the development of anxiety symptoms in middle childhood and should, therefore, be considered in efforts to prevent and treat childhood anxiety.